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Pharmacogenetics of Opioid Use Disorder Treatment

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Abstract

Opioid use disorder (OUD) is a significant health problem in the United States and many other countries. A combination of issues, most notably increased prescription of opioid analgesics, has resulted in climbing rates of opioid abuse and overdose over the last decade. This ongoing epidemic has produced a growing population of patients requiring treatment for OUD. Medications such as methadone and buprenorphine have well documented success rates in treating the disorder compared with placebo. However, significant percentages of the population still fail to maintain abstinence or reduce illicit opioid use while using such medications. Genetic variation may play a role in this variability in outcome through pharmacokinetic or pharmacodynamic effects on OUD medications, or by affecting the rate of negative side effects and adverse events. This review focuses on the existing literature on the pharmacogenetics of OUD treatment, with specific focus on medication metabolism, treatment outcomes, and adverse events.

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  1. Translational Research Laboratories, Department of Psychiatry, Center for Neurobiology and Behavior, University of Pennsylvania School of Medicine, 125 South 31st Street, Room 2207, Philadelphia, PA, 19104, USA

    Richard C. Crist & Wade H. Berrettini

  2. Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK

    Toni-Kim Clarke

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  1. Richard C. Crist
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Correspondence to Richard C. Crist.

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Dr Crist was supported by National Institute on Drug Abuse grant K01 DA036751. Dr Clarke is funded by the Wellcome Trust (Wellcome Trust Strategic Award ‘STratifying Resilience and Depression Longitudinally’ [STRADL] Reference 104036/Z/14/Z). Dr Berrettini was supported by National Institute on Drug Abuse grant R01 DA044015. The funding sources had no role in preparation, review, or approval of the manuscript.

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Drs Crist, Clarke, and Berrettini declare that they have no conflicts of interest.

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Crist, R.C., Clarke, TK. & Berrettini, W.H. Pharmacogenetics of Opioid Use Disorder Treatment. CNS Drugs 32, 305–320 (2018). https://doi.org/10.1007/s40263-018-0513-9

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