Multiple variants of genes working together to increase an individual’s vulnerability to developing and addiction are at play with self exposure to opiates, alcohol, cocaine, and other drugs of abuse; research has shown each drug of abuse causes profound changes in gene expression of multiple genes, especially in the case of opioids, stress responsive systems, and class neurotransmitters that result in changes of behaviors, according to Mary Jeanne Kreek professor and head of Laboratory of Biology of Addictive Diseases at The Rockefeller University.
In regards to the current opioid crisis she says there are three important points: 1) Physicians should prescribe to a maximum of one week of opiates as only 1 to 3 days is needed in most patients; 2) Naloxone is a safe short acting treatment for opiate overdose that should be available at affordable pricing for medical personnel, first responders, and people who interact with others addicted to opiates; and 3) methadone maintenance pharmacotherapy and buprenorphine naloxone maintenance should be available more widely with the excessively stringent regulations governing maintenance treatments made more relaxed at federal and state levels to more effectively treat addiction.
Specific medications for treatments of specific addictive diseases should be used more extensively; nalmefene and naltrexone are effective in 20 to 40 % of alcoholic patients, especially so in cases with patients having one or two copies of A118G variant of the mu opioid receptor. Pharmacotherapeutic options to treat cocaine and other stimulant are not currently available, she adds her lab is currently working hard to synthesize potential treatments for cocaine and alcohol dependency.
