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Int J Genom Data Min. 2018;2018(1). pii: 115. doi: 10.29014/IJGD-115.000015. Epub 2018 Jan 15.

The Benefits of Genetic Addiction Risk Score (GARS) Testing in Substance Use Disorder (SUD).

Blum K1,2,3,4,5,6,7,8,9,10,11, Modestino EJ12, Gondre-Lewis M11,13,14, Chapman EJ15, Neary J8, Siwicki D8, Baron D2, Hauser M3, Smith DE16, Roy AK17, Thanos PK18, Steinberg B12, McLaughlin T19, Fried L5, Barh D10, Dunston GA11, Badgaiyan RD1,2,3,4,5,6,7,8,9,10,12,11,13,14,15,16,17,18,19.

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 Medicine University of Southern California, Los Angeles, CA, USA.
3
Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA.
4
Department of Neurogenetics, Igene, LLC, Austin, TX, USA.
5
Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA.
6
Eötvös Loránd University, Institute of Psychology, Budapest, Hungary.
7
Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE), USA.
8
Division of Precision Medicine, Geneus Health, LLC, USA.
9
Department of Psychiatry, Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, VT, USA.
10
Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, India.
11
NeuroPsychoSocial Genomics Core, National Human Genome Center, Howard University, Washington, DC, USA.
12
Department of Psychology, Curry College, Milton, MA, USA.
13
Developmental Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA.
14
Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, USA.
15
Department of Medicine, Howard University College of Medicine, Washington, DC, USA.
16
David E. Smith Associates, San Francisco, CA, & Institute of Health & Aging University of California, San Francisco, CA, USA.
17
Addiction Recovery Resources, Inc. New Orleans, LA, USA.
18
Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA.
19
Center for Psychiatric Medicine Lawrence, MA, USA.

Abstract

Following 25 years of extensive research by many scientists worldwide, a panel of ten reward gene risk variants, called the Genetic Addiction Risk Score (GARS), has been developed. In unpublished work, when GARS was compared to the Addiction Severity Index (ASI), which has been used in many clinical settings, GARS significantly predicted the severity of both alcohol and drug dependency. In support of early testing for addiction and other RDS subtypes, parents caught up in the current demographic of 127 people, both young and old, dying daily from opiate/opioid overdose, need help. In the past, families would have never guessed that their loved ones would die or could be in real danger due to opiate addiction. Author, Bill Moyers, in Parade Magazine, reported that as he traveled around the United States, he found many children with ADHD and other spectrum disorders like Autism, and noted that many of these children had related conditions like substance abuse. He called for better ways to identify these children and treat them with approaches other than addictive pharmaceuticals. To our knowledge, GARS is the only panel of genes with established polymorphisms reflecting the Brain Reward Cascade (BRC), which has been correlated with the ASI-MV alcohol and drug risk severity score. While other studies are required to confirm and extend the GARS test to include other genes and polymorphisms that associate with an hypodopaminergic trait, these results provide clinicians with a non-invasive genetic test. Genomic testing, such as GARS, can improve clinical interactions and decision-making. Knowledge of precise polymorphic associations can help in the attenuation of guilt and denial, corroboration of family gene-o-grams; assistance in risk-severity-based decisions about appropriate therapies, including pain medications and risk for addiction; choice of the appropriate level of care placement (i.e., inpatient, outpatient, intensive outpatient, residential); determination of the length of stay in treatment; determination of genetic severity-based relapse and recovery liability and vulnerability; determination of pharmacogenetic medical monitoring for better clinical outcomes (e.g., the A1 allele of the DRD2 gene reduces the binding to opioid delta receptors in the brain, thus, reducing Naltrexone's clinical effectiveness); and supporting medical necessity for insurance scrutiny.

KEYWORDS:

African-Americans; Benefits; Genetic Addiction Risk Score (GARS); Hypodopaminergia; P450 system; Pro-dopamine regulation; Reward Deficiency Syndrome (RDS)

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