Buprenorphine Response as a Function of Neurogenetic Polymorphic Antecedents: Can Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome (RDS)?Kenneth Blum1-6*, Marlene Oscar-Berman7, William Jacobs1, Thomas McLaughlin8 and Mark S. Gold1
- Corresponding Author:
- Kenneth Blum
Department of Psychiatry & McKnight Brain Institute
University of Florida College of Medicine, Gainesville, FL, USA
Received date: May 07, 2014; Accepted date: June 28, 2014; Published date: July 05, 2014
Citation: Kenneth Blum, Marlene Oscar-Berman, William Jacobs, Thomas McLaughlin, Mark S. Gold (2014) Buprenorphine Response as a Function of Neurogenetic Polymorphic Antecedents: Can Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome (RDS)? . J Addict Res Ther 5:185. doi:10.4172/2155-6105.1000185
Copyright: © 2014 Blum K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
There is a plethora of research indicating the successful treatment of opioid dependence with either buprenorphine alone or in combination with naloxone (Suboxone®). However, we encourage caution in long-term maintenance with these drugs, albeit, lack of any other FDA approved opioid maintenance compound to date. Our concern has been supported by severe withdrawal (even with tapering of the dosage of for example Suboxone® which is 40 times more potent than morphine) from low dose of buprenorphine (alone or with naloxone). In addition our findings of a long-term flat affect in chronic Suboxone® patients amongst other unwanted side effects including diversion and suicide attempts provides impetus to reconsider long-term utilization. However, it seems prudent to embrace genetic testing to reveal reward circuitry gene polymorphisms especially those related to dopaminergic pathways as well as opioid receptor(s) as a way of improving treatment outcomes. Understanding the interaction of reward circuitry involvement in buprenorphine effects and respective genotypes provide a novel framework to augment a patient’s clinical experience and benefits during opioid replacement therapy.