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EC Psychol Psychiatr. 2018 Aug;7(8):564-579. Epub 2018 Jul 30.

Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

Author information

1
Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville FL. USA.
2
Department of Psychiatry and Behavioral Sciences, Keck School of Medicine University of Southern California, Los Angeles, CA, USA.
3
Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University, Dayton, OH, USA.
4
Department of Psychiatry, University of Vermont, School of Medicine, Burlington, VM., USA.
5
Division of Addictive Services, Dominion Diagnostics, LLC, North Kingston, RI, USA.
6
Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, USA.
7
Department of Psychology, Eotvos Loránd University, Institute of Psychology, Budapest, Hungary.
8
Western University Health Sciences, Pomona, CA, USA.
9
Division of Neurogenetic Research and Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA.
10
Department of Psychology, Curry College, Milton, MA, USA.
11
Department of Psychiatry, Ichan at Mount Sinai School of Medicine, New York, NY, USA.
12
Department of Psychology, and Institute of Addiction Research, University of Buffalo, Buffalo, NY, USA.
13
Department of Psychiatry, Cooper University School of Medicine, Camden NJ, USA.
14
Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, USA.

Abstract

Blum's laboratory first showed the benefits of naloxone or narcotic antagonists in the treatment of alcohol dependence. This seminal work published in Nature in the early 70's, in conjunction with many other studies, later served as the basis for the development of the narcotic antagonist (NTX) now used to treat both alcohol and opioid dependence. In 2006 an extended-release injectable of Naltrexone (XR-NTX) was approved by the FDA. Naltrexone is a relatively weak antagonist of κ- and δ-receptors and is also a potent μ-receptor antagonist. Dosages of naltrexone that effectively reduce opioid and alcohol consumption also actively block μ-receptors, but chronically down-regulate mesolimbic dopamine release. While studies show benefit especially in the short term, there is ongoing evidence that the retention and compliance with NTX are not sufficient to characterize adherence as high. However, extended-release NTX opioid treatment is associated with superior outcomes including less likely relapse (defined as daily use), and much longer time to relapse despite higher rates of concurrent non-opioid substance use like cocaine. Regarding long-term extended-release injectable (XR-NTX) for opioid dependence; there was higher compliance with Opioid Use Disorder (OUD) than for Alcohol Use Disorder (AUD.). Consideration of modalities in combination with XR-NTX is imperative. Research by Blum., et al. showed that a combination of Naltrexone and a pro-dopamine regulator neuro-nutrient (KB220) significantly prevented opioid relapse. Thus, early identification of addiction vulnerability with the Genetic Addiction Risk Score (GARS™) a panel of polymorphic risk alleles from ten reward circuitry genes will provide valuable information especially as it relates to genetically guided therapy with the KB220 neuro nutrient termed 'Precision Addiction Management".

KEYWORDS:

Combination Therapy; Extended-Release Injectable Naltrexone (XR-NTX); Neuronutrient; Opioid Treatment; Reward Deficiency

PMID:
30417173
PMCID:
PMC6226033

Conflict of interest statement

Conflict of Interest Drs. Blum and Siwicki are member of the Board of Directors and own stock in both Geneus Health. LLC. and RestoreGen LLC., exclusive distributors of the Genetic Addiction Risk Score(GARS)™ and KB220PAM of Blum’s patents issued and pending. Dr. Blum is the Chief Scientific Advisor of Dominion Diagnostics and Dr. Siwicki is a member of the Board of Directors. Dr. Blum is Chief Neurogenetics and Addiction Therapy advisor of Florida House. Dr. Blum is Chairman of the Board and CSO of Geneus Health and Drs. Modestino, Badgaiyan, Baron, Thanos, Elman, Siwicki, Febo, and Gold. Are on Geenus Health Scientific Advisory Board.

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