Right now, getting the nation’s opioid addiction epidemic under control is a top priority for public health officials. Overdose deaths continue to climb, with nearly 19,000 deaths related to prescription opioid painkillers and more than 10,000 deaths related to heroin in 2014 alone. I used to be on heroin. I will never forget the feeling of desperately wanting to stop using, but being so physically addicted and so emotionally crippled that there wasn’t a choice anymore.
I can’t blame my addiction on an injury that gave me access to prescription painkiller that opened a gateway to slamming heroin. But I can say that there were several times when I was doing pretty well (not exactly clean, but not doing hard drugs) and prescription pain pills led me back to heroin. What if there had been a way for my doctors to understand the risk of prescribing somebody like me a bottle of 60 Percocet?
Recently, CBS News reported that a company called Proove Bioscience, in Irvine, California, has developed a cheek-swab DNA test that, when combined with a questionnaire, identifies an individual’s likelihood of becoming addicted to opiates. According to the article, about 300 doctors in the US are already using this DNA test to predict addiction in their patients who may in the high-risk category (like their parents are addicts or they have a history of substance abuse) in order to help them make wise decisions about pain management.
Who is an Addict?
Addiction is estimated to be about 50% genetic. That means the other half of the risk comes from environmental, social and cultural factors. External things like peer pressure, individual coping skills, chronic pain, depression and the addictive properties of the drugs used definitely play a part. In recent years, scientists have busily been studying the roots of addiction from a genetic standpoint. Researchers have identified numerous genes that affect the risk for dependence on alcohol and other drugs. These include genes involved in alcohol metabolism as well as in the transmission of nerve cell signals and regulation of certain kinds of nerve activity.
The Proove DNA swab tests a panel of 12 genetic variants, including those in opioid receptors, as well as the receptors for other feel-good brain chemicals like serotonin and dopamine. That genetic data is then combined with the results of the self-assessment survey to come up with a prediction for how likely an individual is to get hooked on opiates. It seems like just a matter of time before science cracks the code on exactly what makes one person and addict and another the kind of weirdo that can have just one glass of wine with dinner.
Haters Gonna Hate
Critics have dismissed the efficacy of the Proove DNA test for lack of peer-reviewed evidence. In the CBS article, Dr. Richard Friedman, a professor of clinical psychiatry at Weill Cornell Medical School, said the Proove tests “cannot be taken seriously by scientists, clinicians, and, most importantly, the public” until they are peer-reviewed. Basically this means that the research behind the DNA test hasn’t been published for other geneticists to scrutinize.
In response to the critics, Proove plans to publish its research in the coming months. In the meantime, this test is already available to physicians because the FDA restrictions for these types of tests administered by a doc are a little more lax than those available to the general public. If this test can be simultaneously reviewed by the medical community and tested on those who it has the most potential to help, what’s the harm?
An Ounce of Prevention
I’m one of those people who think I was born an addict. From my earliest memories, I was doing irrational, compulsive shit that nobody understood. I hated the way my mom made my bed, so I would mess it up and make it again—my way. I developed insane phobias, like the time my brand new pair of sneakers looked like scary tigers, so I absolutely refused wear them. Basically, I was a fucking nightmare. My weird, obsessive behaviors were driven by a deep sense of discomfort and discontent I could never explain. It was almost like an itch and I couldn’t feel okay until I did something (destructive) to scratch it. As I grew up, I discovered that alcohol, and eventually drugs, killed that itch. But what if there had been a test that I could have taken that would tell my parents I was at risk for developing an addiction?
A few weeks ago, we examined a new substance abuse prevention program for kids called Preventure. It aims to recognize how a child’s traits and temperament can determine their risk for drug addiction. The program identifies kids who possess those characteristics and starts giving them tools to undo them almost immediately. God knows I would have scored off the charts wacko on that Preventure test. Until I found recovery as a young adult, I could never put into words exactly why I needed to cut up my new clothes or rearrange my dolls 65 times before I could go to bed—I just had to. Now science has taken addiction prediction to a whole new level and I can’t help but feel hopeful that a whole new generation of little nightmares may be able to avoid becoming addicts.