MORGANTOWN — What if the answer to stopping opioid addiction could be found in your DNA?
If doctors could predict who among us are genetically inclined to addiction?
And what if opioids can still be used for the purpose for which they were created — stopping pain — but are paired with other drugs that block the pleasure receptors that cause some people to become addicted?
The fight to combat opioid addiction is being carried out in research work at West Virginia University.
David Sideroski, Vincent Setola and graduate student Shane Kaski are at the forefront of this research.
Sideroski is department chair and E.J. Van Liere Medicine Professor in the WVU School of Medicine, Department of Physiology, Pharmacology and Neuroscience.
Setola is an assistant professor in the WVU School of Medicine and PI/director of the Laboratory of Neuroscience and Genetics of Substance Abuse. He formerly worked with the National Institutes of Mental Health.
It’s in your genes
Working with 60 patients at the Comprehensive Opioid Addiction Treatment (COAT) clinic, patients who are currently being treated for addiction, Setola has, “tested certain variations in genes that he believes either predispose someone to be addicted or more importantly helps or hinders their ability to recover,” Siderovski said.
There’s a push globally for more personalized medicine, Siderovski said. In the future, if a physician is thinking about what to prescribe for pain, he or she may request a genetic panel to predict whether the patient is likely to become addicted.
A gene profile may also help tailor treatments to help people kick addiction, he said.
“For a long time it’s been known that people’s genetic makeup contributes to their predisposition to abuse drugs, but we were interested in a particular set of genes that hadn’t been studied yet,” Setola said.
What the researchers found was some “novel gene variants that were associated with drug abuse,” he said.
“The products of these genes are targets that drugs can be designed against,” Setola said. “These could lead to novel medications for the treatment of opioid use disorder.”
The change toward looking at genes as part of a patient’s treatment is already happening in medicine, Siderovski said. Huntington’s Disease is an example of something people can discover whether they will develop through a genetic test.
And genetic profiling is getting cheaper — $1,000 to sequence a person’s DNA, Siderovski said.
But while some people will want to know, some may choose not to.
Clinicians he has worked with at Chestnut Ridge are excited about the possibility of having this new tool in addiction diagnosis and treatment, Siderovski said.
It will be a decade or two before this new addiction treatment is available. Development of medicines, testing and FDA approval are all needed. The next step in the genetic study will be to look at a larger population — hundreds — from other clinics and see if the results are the same.
“We are entering a brave new world,” Siderovski said.
The study is unique for West Virginia because of the state’s unique populations, Siderovski said. Studies done in Massachusetts and elsewhere are different because their populations are different.
“We are far different in our opioid addiction than other locales,” he said. “So even though genetic analysis is being done by others elsewhere, the findings that we have are going to be uniquely West Virginian and are going to help us treat the unique West Virginia problem.”
Drugs fighting drugs
Kaski’s research involves using a drug that reduces the addictive effect of the opioid but allows it to retain its effectiveness as a pain reducer.
Kaski is an M.D. PhD student. He said that he had an interest in nerves and brain behavior. When he lost a loved one to heroin addiction, it gave him a personal motivation to find solutions.
He has been doing research for two years and now can prevent mice from being addicted.
“We’ve actually found a drug that, when used with morphine, at least in mice, alleviates the addictive potential but [preserves] the analgesic potential of opioids,” Setola said. “So they’re painkillers, and they’re not addictive.”
That’s important because opioids are still the most effective painkillers for cancer pain, post-operative pain, chronic pain and some other conditions.
The researchers are also looking at neonatal abstinence syndrome to discover why some babies of mothers who use drugs develop the syndrome and some do not.
All of the research is overseen by the WVU Office of Research Integrity and Compliance, from proposal to the end.
Setola and Kaski are writing an article about their findings for a professional journal.
Kaski received funding from the National Institutes on Drug Abuse for his research.
