The Benefits of Genetic Addiction Risk Score (GARS) Testing in Substance Use Disorder (SUD).

Kenneth Blum, Edward J Modestino, Marjorie Gondre-Lewis, Edwin J Chapman, Jennifer Neary, David Siwicki, David Baron, Mary Hauser, David E Smith, Alphonse Kenison Roy, Panayotis K Thanos, Bruce Steinberg, Thomas McLaughlin, Lyle Fried, Debmalya Barh, Georgia A Dunston, Rajendra D Badgaiyan
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引用次数: 65

Abstract

Following 25 years of extensive research by many scientists worldwide, a panel of ten reward gene risk variants, called the Genetic Addiction Risk Score (GARS), has been developed. In unpublished work, when GARS was compared to the Addiction Severity Index (ASI), which has been used in many clinical settings, GARS significantly predicted the severity of both alcohol and drug dependency. In support of early testing for addiction and other RDS subtypes, parents caught up in the current demographic of 127 people, both young and old, dying daily from opiate/opioid overdose, need help. In the past, families would have never guessed that their loved ones would die or could be in real danger due to opiate addiction. Author, Bill Moyers, in Parade Magazine, reported that as he traveled around the United States, he found many children with ADHD and other spectrum disorders like Autism, and noted that many of these children had related conditions like substance abuse. He called for better ways to identify these children and treat them with approaches other than addictive pharmaceuticals. To our knowledge, GARS is the only panel of genes with established polymorphisms reflecting the Brain Reward Cascade (BRC), which has been correlated with the ASI-MV alcohol and drug risk severity score. While other studies are required to confirm and extend the GARS test to include other genes and polymorphisms that associate with an hypodopaminergic trait, these results provide clinicians with a non-invasive genetic test. Genomic testing, such as GARS, can improve clinical interactions and decision-making. Knowledge of precise polymorphic associations can help in the attenuation of guilt and denial, corroboration of family gene-o-grams; assistance in risk-severity-based decisions about appropriate therapies, including pain medications and risk for addiction; choice of the appropriate level of care placement (i.e., inpatient, outpatient, intensive outpatient, residential); determination of the length of stay in treatment; determination of genetic severity-based relapse and recovery liability and vulnerability; determination of pharmacogenetic medical monitoring for better clinical outcomes (e.g., the A1 allele of the DRD2 gene reduces the binding to opioid delta receptors in the brain, thus, reducing Naltrexone's clinical effectiveness); and supporting medical necessity for insurance scrutiny.

遗传成瘾风险评分(GARS™)测试在物质使用障碍(SUD)中的益处。
经过世界各地许多科学家25年的广泛研究,一个由10个奖励基因风险变异组成的小组被称为遗传成瘾风险评分(GARS)。在未发表的研究中,将GARS与许多临床环境中使用的成瘾严重程度指数(ASI)进行比较,GARS显著地预测了酒精和药物依赖的严重程度。为了支持成瘾和其他RDS亚型的早期检测,目前每天有127人(包括年轻人和老年人)死于阿片类药物/阿片类药物过量,父母需要帮助。在过去,家人永远不会想到他们的亲人会因为鸦片成瘾而死亡或处于真正的危险之中。作者比尔·莫耶斯在《游行》杂志上报道说,当他在美国旅行时,他发现许多儿童患有多动症和其他谱系障碍,如自闭症,并注意到这些儿童中的许多人都有药物滥用等相关疾病。他呼吁找到更好的方法来识别这些儿童,并使用除成瘾性药物之外的方法来治疗他们。据我们所知,GARS是唯一具有反映脑奖励级联(BRC)的已确定多态性的基因组,BRC与ASI-MV酒精和药物风险严重程度评分相关。虽然需要其他研究来证实和扩展GARS测试,以包括与低多巴胺能性状相关的其他基因和多态性,但这些结果为临床医生提供了一种非侵入性的基因测试。基因组测试,如GARS,可以改善临床互动和决策。精确的多态关联的知识可以帮助减轻内疚和否认,确证家庭基因o-g;协助根据风险严重程度决定适当的治疗方法,包括止痛药和成瘾风险;选择适当的护理安置水平(即,住院、门诊、重症门诊、住院);确定治疗停留时间;基于遗传严重性的复发和恢复责任和脆弱性的确定;确定药物遗传医学监测以获得更好的临床结果(例如,DRD2基因的A1等位基因减少了与大脑中阿片受体的结合,从而降低了纳曲酮的临床有效性);支持医疗保险审查的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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