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Biomed J Sci Tech Res. 2018 Jan 7;2(2):1-4. doi: 10.26717/BJSTR.2018.02.000738.

Promoting Precision Addiction Management (PAM) to Combat the Global Opioid Crisis.

Author information

1
Department of Psychiatry, Wright State University, USA.
2
Department of Psychiatry, University of Florida College of Medicine, USA.
3
Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, USA.
4
Division of Applied Clinical Research & Education, Dominion Diagnostics, USA.
5
Department of Precision Medicine, Geneus Health LLC, USA.
6
Department of Clinical Neurology, Path Foundation, USA.
7
Institute of Psychology, Eötvös Loránd University, USA.
8
National Human Genome Center at Howard University, USA.
9
Department of Psychiatry, University of Vermont, USA.
10
Department of Psychology, Curry College, USA.
11
Department of Anatomy, Howard University College of Medicine, USA.
12
Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, USA.
13
Center for Psychiatric Medicine, USA.
14
Department of Psychiatry, Icahn School of Medicine, USA.

Abstract

It is universally agreed that dopamine is a major neurotransmitter in terms of reward dependence, however, there remains controversy regarding how to modulate its role clinically to treat and prevent relapse for both substance and non-substance-related addictive behaviors. It is also agreed by most that there is a need to provide early genetic identification possibly through a novel researched technology referred to Genetic Addiction Risk Score(GARS).™ The existing FDA-approved medications promote blocking dopamine, however, we argue that a more prudent paradigm shift should be biphasic-short-term blockade and long-term upregulation, enhancing functional connectivity of brain reward. It is critical to understand that the real phenotype is not any specific drug or non -drug addictive behavior, but instead is Reward Deficiency Syndrome (RDS). Thus the true phenotype of all addictive behaviors is indeed RDS. Finally, we are suggesting that one way to combat the current out of control Opioid /Alcohol crisis worldwide is to seriously reconsider treating RDS by simply supplying powerful narcotic agents (e.g. Buprenorphine). This type of treatment will only keep people addicted. A more reasonable solution involving genetic testing, urine drug screens using Comprehensive Analysis of Reported Drugs (CARD) and dopamine homeostasis we call " Precision Addiction Management" ™ seems parsonomiuos.

KEYWORDS:

Genetic addiction risk score; Hypo dopaminergic; Pro-dopamine regulation; Reward deficiency syndrome

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