Translational Research Laboratories, Department of Psychiatry, Center for Neurobiology and Behavior, University of Pennsylvania School of Medicine, 125 South 31st Street, Room 2207, Philadelphia, PA, 19104, USA.
Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK.
CNS Drugs. 2018 Apr;32(4):305-320. doi: 10.1007/s40263-018-0513-9.
Opioid use disorder (OUD) is a significant health problem in the United States and many other countries. A combination of issues, most notably increased prescription of opioid analgesics, has resulted in climbing rates of opioid abuse and overdose over the last decade. This ongoing epidemic has produced a growing population of patients requiring treatment for OUD. Medications such as methadone and buprenorphine have well documented success rates in treating the disorder compared with placebo. However, significant percentages of the population still fail to maintain abstinence or reduce illicit opioid use while using such medications. Genetic variation may play a role in this variability in outcome through pharmacokinetic or pharmacodynamic effects on OUD medications, or by affecting the rate of negative side effects and adverse events. This review focuses on the existing literature on the pharmacogenetics of OUD treatment, with specific focus on medication metabolism, treatment outcomes, and adverse events.
阿片类药物使用障碍（OUD）是美国和许多其他国家的一个重大健康问题。一系列问题，尤其是阿片类镇痛药处方的增加，导致过去十年阿片类药物滥用和过量的比例不断上升。这种持续的流行导致需要治疗 OUD 的患者人数不断增加。与安慰剂相比，美沙酮和丁丙诺啡等药物在治疗该疾病方面具有良好的记录成功率。然而，仍有相当比例的人群在使用这些药物时无法保持戒断或减少非法阿片类药物的使用。遗传变异可能通过对 OUD 药物的药代动力学或药效学作用，或通过影响负面副作用和不良事件的速度，在这种结果的可变性中发挥作用。这篇综述重点介绍了 OUD 治疗的药物遗传学现有文献，特别关注药物代谢、治疗结果和不良事件。
