A New Tool in the Fight Against Opioid Addiction

Use of prescription opioids remains one of the major pathways to developing an opioid use disorder. Some people can become dependent after even a brief exposure to opioids. We’ve long suspected that there was a genetic basis to opioid use disorder (OUD), and there are certainly genes that are predictive in nature, but there was little that could be done to know who was at higher risk in using opioids, until now.

AvertD is the first genetic assay for OUD, and it was recently approved by the FDA for use in those over the age of 18. When used as part of a complete clinical evaluation and risk assessment prior to prescribing oral opioids for acute pain, AvertD may help to identify patients who have an elevated genetic risk for developing OUD.

Information is power, especially when it comes to healthcare. AvertD marks the first time patients will have access to information about whether they have an elevated risk for opioid use disorder before they are prescribed an opioid for acute pain. Because the test is given well in advance of any medical or dental procedure, our hope is that AvertD empowers patients and providers to have an open, informed dialogue about a safe and effective pain management strategy for acute postprocedural pain. AvertD is not for patients being treated for chronic pain.

AvertD’s goal is not to withhold opioids from someone in acute pain, but rather to allow for informed decisions about how opioids should be used, ensuring that a patient and family are aware that there's a potentially higher risk of developing an opioid use disorder if exposed to opioid pain medication. The healthcare practitioner may choose to start with a shorter course of opioids and then quickly switch over to other pain therapies. For example, a combination of ibuprofen and acetaminophen can provide very powerful pain relief, equivalent to six milligrams of morphine.

Why we need this test

Advancements in genetics and genetic testing are changing the way we prevent and treat diseases. Caron envisions the same evolution taking place within behavioral health and substance use disorder treatment. AvertD is a milestone for addiction treatment by giving us a tool to assess risk – and, perhaps, prevent – the chronic disease of an opioid addiction.

AvertD has the potential to save countless families from the heartbreak of ever experiencing an opioid use disorder. This is a potentially lifesaving test, and it addresses a major unmet medical need.

More than 131 million opioid prescriptions were dispensed last year. While surgeons in the U.S have cut the total amount of opioid painkillers prescribed postoperatively to only a third of what they prescribed in 2016, opioids are still frequently used in the U.S. to treat acute pain by surgically focused specialties. There’s a perception that the new regulations restricting the prescribing of opioids have stopped people from becoming addicted, but it’s still happening. In the most recent National Survey on Drug Use and Health, 8.5 million people admitted to misusing opioid analgesic prescriptions. Approximately 80% of heroin users have reported they first misused prescription opioids prior to heroin.

Additionally, doctors and dentists have begun withholding necessary opioid pain relief out of fear of triggering an addiction in patients, particularly with those who have never taken opioids before. The availability of AvertD can provide health professionals with an objective tool to relieve that anxiety. Knowledge is power. X rays, MRIs and blood work are helpful in diagnosing and treating patients. Why should the prescribing of necessary pain relief be any different?

The majority of dental offices and surgical teams are likely to welcome this test, because their toolbox presently lacks the tools required to assess the risk of developing an opioid use disorder. The potential risk frequently weighs on providers as they consider starting someone on a medication that could eventually lead to a chronic, progressive, potentially fatal disease. It is likely that everyone who prescribes opioids will see the benefit of utilizing the data from AvertD and incorporating it into this conversation with their patients.

The importance of research in addiction medicine

We’re excited that one of the research projects we collaborated on resulted in AvertD. Caron is committed to medical research that will improve the lives of individuals and families impacted by substance use disorder. No aspect of today’s medicine could succeed without the solid scientific research that advances the prevention, diagnosis, and treatment of the underlying causes of illness. Addiction medicine is no different.