Genetic and environmental risks in opioid use disorder

A new study by researchers from VA Connecticut Healthcare System and Yale School of Medicine looks at how different factors can predict if someone might become addicted to opioids.

Joseph Deak, who works at Yale School of Medicine and helped lead the study, said, “We’ve learned a lot about the genes and things around us that can affect the chances of getting addicted to opioids. But we still don’t fully understand how these factors work together.”

Other recent studies have looked at various things like biology, psychology, and social factors that can affect the risk of opioid addiction. Scientists have also found ways to use genetic information to estimate someone’s risk of addiction, called “polygenic risk scores.” These scores look at genetic data from a person’s whole genome to see if they might have a higher risk of addiction.

In the VA and Yale study, researchers looked at data from 1,958 people who participated in an earlier study called the Yale-Penn study. They wanted to see how different factors, like genetics and life experiences, influence the risk of opioid addiction.

They found that environmental factors, like income and education, were more critical in predicting opioid addiction than genetic factors alone. These ecological factors explained about three times more of the risk compared to just looking at genetic scores for opioid addiction.

Even though environmental factors were more significant, the study showed that genetic scores still played a part in predicting opioid addiction. They accounted for about 8% of the risk.

Joel Gelernter, MD, Foundations Fund Professor of Psychiatry at Yale and senior author of the study, said, “This genetic prediction—based on the best-available full-genome data—is enough to show a solid statistical relationship, but not enough to bring into the clinic.”

Peter Jongho Na, MD, MPH, an addiction psychiatrist at VA Connecticut Healthcare System, US Department of Veterans Affairs Career Development Investigator, assistant professor of psychiatry at Yale School of Medicine, and co-lead author of the study, said, “While the field has made significant advances in understanding the genetic predictability of opioid use disorder, our results suggest that the current genetic predictors do not yet have the utility for a clinically meaningful prediction. But importantly, they suggest that interventions and policy measures that target modification of environmental factors may help mitigate the risk for opioid use disorder.” 

Although we’ve learned a lot about how genes can predict opioid addiction, our findings show that these genetic predictors aren’t reliable enough for practical use in clinics yet. However, we’ve discovered that focusing on changing environmental factors could help lower the risk of opioid addiction through interventions and policy changes.

In conclusion, while genetic predictors for opioid use disorder have advanced, they are not yet clinically reliable for predicting addiction. However, targeting environmental factors through interventions and policy measures could help mitigate the risk of opioid use disorder.

Journal reference:

Peter J. Na, Joseph D. Deak et al., Genetic and non-genetic predictors of risk for opioid dependence. Psychological Medicine. DOI: 10.1017/S0033291723003732.

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