1
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Blum K, Gold MS, Cadet JL, Gondre-Lewis MC, McLaughlin T, Braverman ER, Elman I, Paul Carney B, Cortese R, Abijo T, Bagchi D, Giordano J, Dennen CA, Baron D, Thanos PK, Soni D, Makale MT, Makale M, Murphy KT, Jafari N, Sunder K, Zeine F, Ceccanti M, Bowirrat A, Badgaiyan RD. Invited Expert Opinion- Bioinformatic and Limitation Directives to Help Adopt Genetic Addiction Risk Screening and Identify Preaddictive Reward Dysregulation: Required Analytic Evidence to Induce Dopamine Homeostatsis. MEDICAL RESEARCH ARCHIVES 2023; 11:10.18103/mra.v11i8.4211. [PMID: 37885438 PMCID: PMC10601302 DOI: 10.18103/mra.v11i8.4211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Addiction, albeit some disbelievers like Mark Lewis [1], is a chronic, relapsing brain disease, resulting in unwanted loss of control over both substance and non- substance behavioral addictions leading to serious adverse consequences [2]. Addiction scientists and clinicians face an incredible challenge in combatting the current opioid and alcohol use disorder (AUD) pandemic throughout the world. Provisional data from the Centers for Disease Control and Prevention (CDC) shows that from July 2021-2022, over 100,000 individuals living in the United States (US) died from a drug overdose, and 77,237 of those deaths were related to opioid use [3]. This number is expected to rise, and according to the US Surgeon General it is highly conceivable that by 2025 approximately 165,000 Americans will die from an opioid overdose. Alcohol abuse, according to data from the World Health Organization (WHO), results in 3 million deaths worldwide every year, which represents 5.3% of all deaths globally [4].
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Affiliation(s)
- Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX., USA
- Division of Addiction Research & Education, Center for Sports, Exercise & Psychiatry, Western University Health Sciences, Pomona, CA., USA
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT.,USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Centre, Dayton, OH, USA
- Division of Nutrigenomics Research, TranspliceGen Therapeutics, Inc., Austin, Tx., 78701, USA
- Department of Nutrigenomic Research, Victory Nutrition International, Inc., Bonita Springs, FL, USA
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, CA., USA
- Sunder Foundation, Palm Springs, CA, USA
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO., USA
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD., USA
| | - Marjorie C. Gondre-Lewis
- Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC., USA
| | - Thomas McLaughlin
- Division of Nutrigenomics Research, TranspliceGen Therapeutics, Inc., Austin, Tx., 78701, USA
| | - Eric R Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX., USA
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA., USA
| | - B. Paul Carney
- Division Pediatric Neurology, University of Missouri, School of Medicine, Columbia, MO., USA
| | - Rene Cortese
- Department of Child Health – Child Health Research Institute, & Department of Obstetrics, Gynecology and Women’s Health School of Medicine, University of Missouri, MO., USA
| | - Tomilowo Abijo
- Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC., USA
| | - Debasis Bagchi
- Department of Pharmaceutical Sciences, Texas Southern University College of Pharmacy and Health Sciences, Houston, TX, USA
| | - John Giordano
- Division of Personalized Mental Illness Treatment & Research, Ketamine Infusion Clinics of South Florida, Pompano Beach, Fl., USA
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA, USA
| | - David Baron
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY 14203, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14203, USA
| | - Diwanshu Soni
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA., USA
| | - Milan T. Makale
- Department of Radiation Medicine and Applied Sciences, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0819, USA
| | - Miles Makale
- Department of Psychology, UC San Diego, Health Sciences Drive, La Jolla, CA, 92093, USA
| | | | - Nicole Jafari
- Department of Human Development, California State University at long Beach, Long Beach, CA., USA
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, CA., USA
| | - Keerthy Sunder
- Department of Psychiatry, Menifee Global Medical Center, Palm Desert, CA., USA
- Sunder Foundation, Palm Springs, CA, USA
| | - Foojan Zeine
- Awareness Integration Institute, San Clemente, CA., USA
- Department of Health Science, California State University at Long Beach, Long Beach, CA., USA
| | - Mauro Ceccanti
- Società Italiana per il Trattamento dell’Alcolismo e le sue Complicanze (SITAC), ASL Roma1, Sapienza University of Rome, Rome, Italy
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX., USA
- Department of Psychiatry, Mt Sinai University School of Medicine, New York, NY., USA
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2
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Visibelli A, Peruzzi L, Poli P, Scocca A, Carnevale S, Spiga O, Santucci A. Supporting Machine Learning Model in the Treatment of Chronic Pain. Biomedicines 2023; 11:1776. [PMID: 37509416 PMCID: PMC10376077 DOI: 10.3390/biomedicines11071776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Conventional therapy options for chronic pain are still insufficient and patients most frequently request alternative medical treatments, such as medical cannabis. Although clinical evidence supports the use of cannabis for pain, very little is known about the efficacy, dosage, administration methods, or side effects of widely used and accessible cannabis products. A possible solution could be given by pharmacogenetics, with the identification of several polymorphic genes that may play a role in the pharmacodynamics and pharmacokinetics of cannabis. Based on these findings, data from patients treated with cannabis and genotyped for several candidate polymorphic genes (single-nucleotide polymorphism: SNP) were collected, integrated, and analyzed through a machine learning (ML) model to demonstrate that the reduction in pain intensity is closely related to gene polymorphisms. Starting from the patient's data collected, the method supports the therapeutic process, avoiding ineffective results or the occurrence of side effects. Our findings suggest that ML prediction has the potential to positively influence clinical pharmacogenomics and facilitate the translation of a patient's genomic profile into useful therapeutic knowledge.
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Affiliation(s)
- Anna Visibelli
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Luana Peruzzi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Paolo Poli
- POLIPAIN CLINIC, SIRCA Italian Society of Cannabis Research, 56124 Pisa, Italy
| | - Antonella Scocca
- POLIPAIN CLINIC, SIRCA Italian Society of Cannabis Research, 56124 Pisa, Italy
| | - Simona Carnevale
- POLIPAIN CLINIC, SIRCA Italian Society of Cannabis Research, 56124 Pisa, Italy
| | - Ottavia Spiga
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Competence Center ARTES 4.0, 53100 Siena, Italy
- SienabioACTIVE-SbA, 53100 Siena, Italy
| | - Annalisa Santucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Competence Center ARTES 4.0, 53100 Siena, Italy
- SienabioACTIVE-SbA, 53100 Siena, Italy
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3
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Babayeva M, Loewy ZG. Cannabis Pharmacogenomics: A Path to Personalized Medicine. Curr Issues Mol Biol 2023; 45:3479-3514. [PMID: 37185752 PMCID: PMC10137111 DOI: 10.3390/cimb45040228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Cannabis and related compounds have created significant research interest as a promising therapy in many disorders. However, the individual therapeutic effects of cannabinoids and the incidence of side effects are still difficult to determine. Pharmacogenomics may provide the answers to many questions and concerns regarding the cannabis/cannabinoid treatment and help us to understand the variability in individual responses and associated risks. Pharmacogenomics research has made meaningful progress in identifying genetic variations that play a critical role in interpatient variability in response to cannabis. This review classifies the current knowledge of pharmacogenomics associated with medical marijuana and related compounds and can assist in improving the outcomes of cannabinoid therapy and to minimize the adverse effects of cannabis use. Specific examples of pharmacogenomics informing pharmacotherapy as a path to personalized medicine are discussed.
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Affiliation(s)
- Mariana Babayeva
- Department of Biomedical and Pharmaceutical Sciences, Touro College of Pharmacy, New York, NY 10027, USA
| | - Zvi G Loewy
- Department of Biomedical and Pharmaceutical Sciences, Touro College of Pharmacy, New York, NY 10027, USA
- Department of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA
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Neurogenetic and Epigenetic Aspects of Cannabinoids. EPIGENOMES 2022; 6:epigenomes6030027. [PMID: 36135314 PMCID: PMC9498086 DOI: 10.3390/epigenomes6030027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
Cannabis is one of the most commonly used and abused illicit drugs in the world today. The United States (US) currently has the highest annual prevalence rate of cannabis consumption in the world, 17.9% in individuals aged 12 or older, and it is on the rise. With increasing cannabis use comes the potential for an increase in abuse, and according to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 5.1% of Americans had Cannabis Use Disorder (CUD) in 2020. Research has shown that genetics and epigenetics play a significant role in cannabis use and CUD. In fact, approximately 50–70% of liability to CUD and 40–48% of cannabis use initiation have been found to be the result of genetic factors. Cannabis usage and CUD have also been linked to an increased risk of psychiatric disorders and Reward Deficiency Syndrome (RDS) subsets like schizophrenia, depression, anxiety, and substance use disorder. Comprehension of the genetic and epigenetic aspects of cannabinoids is necessary for future research, treatment plans, and the production of pure cannabinoid compounds, which will be essential for FDA approval. In conclusion, having a better understanding of the epigenetic and genetic underpinnings of cannabis use, CUD, and the endocannabinoid system as a whole will aid in the development of effective FDA-approved treatment therapies and the advancement of personalized medicine.
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Gupta A, Bowirrat A, Gomez LL, Baron D, Elman I, Giordano J, Jalali R, Badgaiyan RD, Modestino EJ, Gold MS, Braverman ER, Bajaj A, Blum K. Hypothesizing in the Face of the Opioid Crisis Coupling Genetic Addiction Risk Severity (GARS) Testing with Electrotherapeutic Nonopioid Modalities Such as H-Wave Could Attenuate Both Pain and Hedonic Addictive Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:552. [PMID: 35010811 PMCID: PMC8744782 DOI: 10.3390/ijerph19010552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/16/2021] [Accepted: 12/31/2021] [Indexed: 02/03/2023]
Abstract
In the United States, amid the opioid overdose epidemic, nonaddicting/nonpharmacological proven strategies are available to treat pain and manage chronic pain effectively without opioids. Evidence supporting the long-term use of opioids for pain is lacking, as is the will to alter the drug-embracing culture in American chronic pain management. Some pain clinicians seem to prefer classical analgesic agents that promote unwanted tolerance to analgesics and subsequent biological induction of the "addictive brain". Reward genes play a vital part in modulation of nociception and adaptations in the dopaminergic circuitry. They may affect various sensory and affective components of the chronic pain syndromes. The Genetic Addiction Risk Severity (GARS) test coupled with the H-Wave at entry in pain clinics could attenuate pain and help prevent addiction. The GARS test results identify high-risk for both drug and alcohol, and H-Wave can be initiated to treat pain instead of opioids. The utilization of H-Wave to aid in pain reduction and mitigation of hedonic addictive behaviors is recommended, notwithstanding required randomized control studies. This frontline approach would reduce the possibility of long-term neurobiological deficits and fatalities associated with potent opioid analgesics.
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Affiliation(s)
- Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Luis Llanos Gomez
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA; (L.L.G.); (R.J.); (E.R.B.)
| | - David Baron
- Graduate College, Western University Health Sciences, Pomona, CA 91766, USA;
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA;
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
| | - John Giordano
- South Beach Detox & Treatment Center, North Miami Beach, FL 33169, USA;
| | - Rehan Jalali
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA; (L.L.G.); (R.J.); (E.R.B.)
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX 78249, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA;
| | | | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA; (L.L.G.); (R.J.); (E.R.B.)
| | - Anish Bajaj
- Bajaj Chiropractic, New York, NY 10010, USA;
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA; (L.L.G.); (R.J.); (E.R.B.)
- Graduate College, Western University Health Sciences, Pomona, CA 91766, USA;
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX 78249, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur 721172, West Bengal, India
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Centre, Dayton, OH 45324, USA
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Chen T, Hassan AN, Le Foll B. 3-Year Follow-up of Lower Risk Cannabis Use Patterns: Evidence from a Longitudinal Survey. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:48-56. [PMID: 33657893 PMCID: PMC8811244 DOI: 10.1177/0706743721996118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Following recommendations from the Lower Risk Cannabis Use Guidelines, we evaluated how lower risk cannabis use (late initiation and low use frequency) was associated with the risk of developing cannabis abuse/dependence over a 3-year follow-up period compared to 12-month abstinence (controls) or higher risk cannabis use (early initiation and higher use frequency). We also explored the effect of cannabis quantity. METHODS Data were obtained from the U.S. nationally representative survey, National Epidemiologic Survey on Alcohol and Related Conditions wave I (2001 to 2002) and wave II (2004 to 2005), which included 31,464 respondents with no lifetime history of cannabis abuse/dependence at the first interview. We applied multiple logistic regression and propensity score matching analyses to examine the association between different use patterns at wave I and cannabis abuse/dependence at wave II, adjusting for covariates. Lower risk cannabis use and the transition to higher use frequency were also assessed. RESULTS For propensity score analysis, lower risk cannabis use at wave I was associated with higher risk of cannabis use/dependence at wave II compared to controls (odds ratio [OR]: 4.27; 95% confidence interval [95% CI], 1.57 to 11.61); however, there was no association with use frequency increase (OR: 2.52; 95% CI, 0.88 to 7.17). Higher risk use had a greater risk of cannabis use/dependence than controls (OR: 6.27; 95% CI, 2.56 to 15.38) and lower risk use (OR: 2.69; 95% CI, 1.12 to 6.47). Logistic regression analyses showed similar results, except that lower risk use was significantly associated with use frequency increase (OR: 2.49; 95% CI, 1.22 to 5.08). For the lower risk use group, 1 to 3 joints/day of use was significantly associated with cannabis abuse/dependence. CONCLUSIONS We found that following recommended use patterns can significantly lower one's risk of cannabis abuse/dependence. However, risk of cannabis abuse/dependence is still 4 times higher than staying abstinent. Updated recommendations on safe cannabis exposure levels are needed to guide cannabis use in the general population after cannabis legalization.
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Affiliation(s)
- Tongtong Chen
- Translational Addiction Research Laboratory, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Ontario, Canada
| | - Ahmed N Hassan
- Addiction Division, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Departments of Family and Community Medicine, Psychiatry, and Institute of Medical Sciences, University of Toronto, Ontario, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Ontario, Canada.,Addiction Division, 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Departments of Family and Community Medicine, Psychiatry, and Institute of Medical Sciences, University of Toronto, Ontario, Canada
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7
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González-Roz A, Aonso-Diego G, Martínez-Loredo V, Cuesta M, Secades-Villa R. Effects of Risk Perception and Accessibility on Cannabis Use among Young Population in Spain: Findings from the 2016 National Survey (ESTUDES). Subst Use Misuse 2022; 57:36-46. [PMID: 34678115 DOI: 10.1080/10826084.2021.1981387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BackgroundCannabis use in the young population has undergone a significant increase in Europe. Empirical assessments of individual and contextual mediating variables in relation to cannabis use are informative for prevention actions and have yet to be conducted in Spain. Objectives: This study used the 2016 National Survey on Drug Use in Secondary Education in Spain (ESTUDES) to inform on potentially relevant cannabis prevention targets. We examined individual variables (sex, age, and cannabis risk perception), past 30-day legal and illicit substance use, substance-free activities, and contextual factors (perceived accessibility to cannabis) associated to past 30-day cannabis use. Methods: Data were drawn from 35,369 adolescents (% females: 50.1). Structural equation modeling (SEM) was implemented to identify predictors of cannabis use, and indirect paths were tested via bootstrapping to examine the mediating effects of cannabis risk perception and accessibility. Results: Demographics (male sex, higher age), and past 30-day tobacco, alcohol, and illicit substance use were associated with past 30-day cannabis use. Frequency of past-year engagement in hobbies and reading did also predict past 30-day cannabis use. The mediators worked on most of the relationships examined, except for hobbies and illegal substance use in the case of accessibility and reading and hobbies in the case of risk perception. Conclusions/importance: Cannabis use is more likely to emerge in the event of low risk perception and high accessibility. Lower frequency of past year reading and higher engagement in some hobbies that are often carried out alone represent risk factors, which could potentially influence prevention programs.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Department of Psychology, Research Institute of Health Sciences (IUNICS) - University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Víctor Martínez-Loredo
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Graham DP, Harding MJ, Nielsen DA. Pharmacogenetics of Addiction Therapy. Methods Mol Biol 2022; 2547:437-490. [PMID: 36068473 DOI: 10.1007/978-1-0716-2573-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies with response to treatment based on individual genetic makeup. In this chapter, we will discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The continued elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.
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Affiliation(s)
- David P Graham
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mark J Harding
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David A Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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9
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Gerra ML, Gerra MC, Tadonio L, Pellegrini P, Marchesi C, Mattfeld E, Gerra G, Ossola P. Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement. Neurosci Biobehav Rev 2021; 131:560-580. [PMID: 34606823 DOI: 10.1016/j.neubiorev.2021.09.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022]
Abstract
This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.
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Affiliation(s)
| | - Maria Carla Gerra
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | | | | | - Carlo Marchesi
- Psychiatry Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Elizabeth Mattfeld
- Drug Prevention and Health Branch, Prevention Treatment and Rehabilitation Section, United Nations Office on Drugs and Crime, Vienna, Austria.
| | - Gilberto Gerra
- Department of Mental Health, AUSL of Parma, Parma, Italy.
| | - Paolo Ossola
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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10
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Ossola P, Gerra MC, Gerra ML, Milano G, Zatti M, Zavan V, Volpi R, Marchesi C, Donnini C, Gerra G, Di Gennaro C. Alcohol use disorders among adult children of alcoholics (ACOAs): Gene-environment resilience factors. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110167. [PMID: 33166669 DOI: 10.1016/j.pnpbp.2020.110167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/03/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022]
Abstract
Both genetic and early environmental factors contribute to the pathogenesis of Alcohol Use Disorder (AUD). Gender and psychopathology symptoms might further moderate this association, resulting in an impairment of both the dopaminergic and serotoninergic pathways that sustain the binge, withdrawal and craving cycle. In a sample of of adult children of alcoholic parents (ACOAs) (n = 107) we compared those with and without an AUD, on socio-demographic variables, adverse childhood experiences, psychopathology symptoms and two polymorphisms associated with an impaired serotoninergic and dopaminergic neurotransmission (5HTTLPR and Taq1A/DRD2). A logistic regression revealed that an early caring environment might lower the risk of developing an AUD. When controlling for the actual psychopathology symptoms, being male and having the genotype associated with an impaired dopaminergic neurotransmission were still associated with AUD. Results were confirmed by an unsupervised approach that showed how the clusters characterised by being male and having the high risk genotypes were still associated with AUD compared to being female without the unfavourable dopamine genotype.Our results point to the need for implementing prevention strategies aimed at creating a caring environment especially in those families with an alcoholic parent. We further suggest that psycho-education as a symptom recognition and avoiding self-medication could improve the outcome in those subjects at higher risk, especially males.
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Affiliation(s)
- Paolo Ossola
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Maria Carla Gerra
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - Maria Lidia Gerra
- Department of Mental Health, Local Health Agency Parma, Parma, Italy
| | - Giulia Milano
- Department of Laboratory Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marta Zatti
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Valeria Zavan
- Department of Addiction Pathology, Local Health Agency Alessandria, Alessandria, Italy
| | - Riccardo Volpi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Carlo Marchesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Claudia Donnini
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy.
| | - Gilberto Gerra
- Drug Prevention and Health Branch, Division for Operations, United Nation Office on Drugs and Crime, Vienna, Austria.
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Popescu A, Marian M, Drăgoi AM, Costea RV. Understanding the genetics and neurobiological pathways behind addiction (Review). Exp Ther Med 2021; 21:544. [PMID: 33815617 PMCID: PMC8014976 DOI: 10.3892/etm.2021.9976] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
The hypothesis issued by modern medicine states that many diseases known to humans are genetically determined, influenced or not by environmental factors, which is applicable to most psychiatric disorders as well. This article focuses on two pending questions regarding addiction: Why do some individuals become addicted while others do not? along with Is it a learned behavior or is it genetically predefined? Recent data suggest that addiction is more than repeated exposure, it is the synchronicity between intrinsic factors (genotype, sex, age, preexisting addictive disorder, or other mental illness), extrinsic factors (childhood, level of education, socioeconomic status, social support, entourage, drug availability) and the nature of the addictive agent (pharmacokinetics, path of administration, psychoactive properties). The dopamine-mesolimbic motivation-reward-reinforcement cycle remains the most coherent physiological theory in addiction. While the common property of addictive substances is that they are dopamine-agonists, each class has individual mechanisms, pharmacokinetics and psychoactive potentials.
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Affiliation(s)
- Alexandra Popescu
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Maria Marian
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Ana Miruna Drăgoi
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Radu-Virgil Costea
- Department of General Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Kim AR, Sin JE. Genetic and environmental contributions to psychopathological symptoms in adulthood: Clarifying the role of individual and parental risk factors. Asian J Psychiatr 2020; 53:102195. [PMID: 32563947 DOI: 10.1016/j.ajp.2020.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/27/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Psychopathology-related suicide attempts and deaths are increasing, and the research focus remains on mental disorder in childhood and adolescence. We examined the genetic and environmental contributions to internalizing, externalizing, and general psychopathological distress to clarify the role of individual/parental risk factors for suicide in young adults. Data from 1206 young adults were obtained from a publicly available dataset from the Human Connectome Project. Heritability estimates were analyzed by twin modelling using OpenMx and data from a subsample of 402 monozygotic and dizygotic twins. The estimated prevalence of psychopathological symptoms ranged from 9 to 16%. The heritability of internalizing, externalizing, and general psychopathological distress reached significance, with estimates ranging from 22 to 46%. Shared (common) environments contributed to aggressive behavior (30 %). Determining factors for psychopathological distress (internalizing, externalizing, general) were evaluated using logistic regression analysis. Household income (<$50,000), childhood conduct problems, and maternal drug or alcohol problems were common risk factors of internalizing, externalizing, and general psychopathological distress. Marijuana dependence and maternal anxiety were additional risk factors of externalizing distress. The presence of alcohol and maternal drug or alcohol problems was linked to general psychopathological distress. The results highlight risk factors associated with psychopathological symptoms that should be considered in the early detection of high-risk groups and implementation of family-based interventions. Providing continuous care and/or follow-up in at-risk children and young adults may improve mental health and well-being.
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Affiliation(s)
- Ah Rim Kim
- Department of Nursing, Far East University, 76-32 Daehak-gil, Gamgok-myeon, Eumseong-gun, Chungbuk, 27601, Republic of Korea.
| | - Jae Eun Sin
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do, 10408, Republic of Korea.
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Swenson S, Blum K, McLaughlin T, Gold MS, Thanos PK. The therapeutic potential of exercise for neuropsychiatric diseases: A review. J Neurol Sci 2020; 412:116763. [PMID: 32305746 DOI: 10.1016/j.jns.2020.116763] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/14/2020] [Accepted: 02/28/2020] [Indexed: 02/06/2023]
Abstract
Exercise is known to have a myriad of health benefits. There is much to be learned from the effects of exercise and its potential for prevention, attenuation and treatment of multiple neuropsychiatric diseases and behavioral disorders. Furthermore, recent data and research on exercise benefits with respect to major health crises, such as, that of opioid and general substance use disorders, make it very important to better understand and review the mechanisms of exercise and how it could be utilized for effective treatments or adjunct treatments for these diseases. In addition, mechanisms, epigenetics and sex differences are examined and discussed in terms of future research implications.
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Affiliation(s)
- Sabrina Swenson
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Kenneth Blum
- Western Univesity Health Sciences, Graduate College, Pomona, CA, USA
| | | | - Mark S Gold
- Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY, USA; Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA.
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Determining Risks for Cannabis Use Disorder in the Face of Changing Legal Policies. CURRENT ADDICTION REPORTS 2019; 6:466-477. [PMID: 33312839 DOI: 10.1007/s40429-019-00288-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose of review This review aims to summarize and critically evaluate the current literature on the associations between individual and socio-cultural factors that increase risk for cannabis use disorder (CUD), and policy change. Recent findings Epidemiological studies show that areas with permissive legal cannabis climates are associated with greater individual risk factors for CUD. This includes: (1) higher rates of edible consumption and vaping, (2) higher delta-9-tetrahydrocannabinol (THC) potency and lower cannabidiol (CBD) levels, and, (3) younger age of initiation of use. Summary A change in the socio-cultural level, such as shifts in the legalization of cannabis, could interact with individual-level factors in their associations with CUD. There is currently a lack of empirical studies that evaluate this interaction. We propose that future research consider a bioecological framework for CUD to allow for a comprehensive understanding of the effects of legal climate that could inform policy and clinical practice.
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