Neurogenetics of acute and chronic opiate/opioid abstinence: Treating symptoms and the cause

Kenneth Blum, Mark S. Gold, William Jacobs, William Vaughn McCall, Marcelo Febo, David Baron, Kristina Dushaj, Zsolt Demetrovics, Rajendra D. Badgaiyan

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

This review begins with a comprehensive history of opioid dependence and treatment in the United States. The focus is an evidence-based treatment model for opioid/opiate dependent individuals. The role of reward genetic polymorphisms and the epigenetic modifications that lead to vulnerability to use and misuse of opiates/opioid to treat pain are reviewed. The neurochemical mechanisms of acute opiate withdrawal and opiate/opioid reward mechanisms are explored with a goal of identifying specific treatment targets. Alterations in functional brain connectivity based on neurobiological mechanisms in heroin dependence and abstinence are also reviewed. A new clinical model an alternative to merely blocking acute withdrawal symptoms as identified in the DSM -5 is proposed. Genetic diagnosis at the onset of detoxification, to determine risk stratification, and identify polymorphic gene targets for pharmaceutical and nutraceutical interventions, followed by the simultaneous initiation of Medication Assisted Therapy (MAT), to enable psychological extinction, and steady pro-dopaminergic therapy with the goal of developing "dopamine homeostasis" is recommended. The objective of these interventions is to prevent future relapse by treating all "Reward Deficiency Syndrome" (RDS) behaviors and eventually make an addictionfree life possible.

Original languageEnglish (US)
Pages (from-to)1247-1288
Number of pages42
JournalFrontiers in Bioscience - Landmark
Volume22
Issue number8
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Keywords

  • Acute opiate
  • Anti-opiate dopamine restoration model
  • AODR
  • Dopamine homeostasis
  • Endorphinergic
  • Functional connectivity
  • Glutaminergic and dopaminergic reward mechanisms
  • Opioid abstinence
  • Review
  • Withdrawal

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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