Calgary research explores genetics to unwrap opioid dependency

Several 5-mg pills of Oxycodone are seen June 17, 2019, in Zelienople, Pa. (AP Photo/Keith Srakocic, File)

Researchers in Calgary have found evidence that suggests some people could be genetically predisposed to becoming hooked on opioids.

The work could mean alternative pain management strategies, closer monitoring and even different dosing suggestions, they say.

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The study was conducted by scientists with the University of Calgary’s Faculty of Veterinary Medicine, Cumming School of Medicine and Hotchkiss Brain Institute.

They found a gene called a runt-related transcription factor 1 (RUNX1), which helps control other genes that transmit pain.

Scientists say people can carry different levels of RUNX1 and this variance can influence how patients respond to opioid medications.

“Our work highlights the importance of taking each patient’s genetic make-up into account when making medical decisions,” said Dr. Heather Leduc-Pessah, first author on the study, in a news release.

“This has been especially relevant for my work in pediatric neurology, where personalized medicine and gene therapies are at the forefront.”

To learn more about RUNX1 and its connection with opioid dependency, researchers reviewed genetic data from patients who underwent jaw and abdominal surgeries.

They found those who possess the genetic RUNX1 variant needed higher doses of opioids to achieve pain relief. Others with different variants experienced “more intense withdrawal symptoms,” researchers said.

“Pain management is fundamental to medical and surgical practice and clinicians have long known that the responses to opioid analgesics can be quite surprising and unpredictable from patient to patient,” said Dr. Paul Salo, MD, orthopedic surgeon and clinical professor at the Cumming School of Medicine.

“This can lead to a host of adverse effects, ranging from nausea, vomiting, and inadequate pain relief to oversedation, respiratory depression and of course, dependency.”

Researchers say this basic research can help with clinical understanding of the opioid issue.

“By identifying the cellular and genetic pathways involved, we can start thinking differently about how pain medications are prescribed and monitored,” said principal investigator Dr. Tuan Trang.

The team collaborated with experts from other Canadian universities such as McGill, Laval and Victoria, as well as international teams at Washington University in St. Louis, the University of Sydney in Australia and the University of Tokyo.

The findings have been published in the latest issue of Neuron.