alexa <p>Buprenorphine Response as a Function of Neurogenetic Polymorphic Antecedents: Can Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome (RDS)?</p> | Abstract
ISSN: 2155-6105

Journal of Addiction Research & Therapy
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Commentary

Buprenorphine Response as a Function of Neurogenetic Polymorphic Antecedents: Can Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome (RDS)?

Kenneth Blum1,2,3,4,5,6*, Marlene Oscar-Berman7, William Jacobs1, Thomas McLaughlin8 and Mark S. Gold1
1Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
2Human Integrated Services Unit, University of Vermont Centre for Clinical & Translational Science, College of Medicine, Burlington, VT, USA
3Department of Addiction Research and Therapy, Malibu Beach Recovery Centre, Malibu Beach, CA, USA
4Dominion Diagnostics, LLC, North Kingstown, RI, USA
5Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
6IGENE, LLC, Austin, Texas, USA
7Departments of Psychiatry and Neurology and Anatomy and Neurobiology, Boston University School of Medicine, Boston VA Healthcare System, Boston, MA, 02118, USA
8Center for Psychiatric Medicine, North Andover, Massachusetts, USA
*Corresponding Author: Kenneth Blum, Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA, Tel: 619-8902167, Email: [email protected]

Received Date: May 07, 2018 / Accepted Date: Jun 28, 2014 / Published Date: Jul 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  . 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.

 

Abstract

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.

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