Genetic test for OUD
- Thread starter nvrsumr
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Our group has previously piloted various genetic testing and neuropsych programs for risk stratification. To date, nothing has been much better than an ORT and DIRE for predicting misuse and abuse.
If someone tried to tell me that my bad habits and compulsions were written in my DNA, I'd be pissed.
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Perfect. Patients will come in on 1000mg oxy per day and show you their test that they are fine taking this med.
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Ehhhhh sensitivity and specificity like 80%?
Pretty craptastic and wouldn't be surprised if found to be worse during post-market surveillance.
That said, it's great this test is rolling out. It'll help further legitimize what many still feel is just behavior of the "weak-minded" blah blah blah. Expecting a single lab test alone to determine likelihood of addiction is probably unrealistic. And future iterations and/or competing tests will hopefully be better.
No worries at all regarding the typical patient seeing us wanting COT for MSK pain and saying their addiction test is "negative"; does nothing to change the fact there's no data to support it. And for the particularly persistent, we can remind them this how fallible this test is and that there's still a very real chance they could become addicted to an opioid.
Pretty craptastic and wouldn't be surprised if found to be worse during post-market surveillance.
That said, it's great this test is rolling out. It'll help further legitimize what many still feel is just behavior of the "weak-minded" blah blah blah. Expecting a single lab test alone to determine likelihood of addiction is probably unrealistic. And future iterations and/or competing tests will hopefully be better.
No worries at all regarding the typical patient seeing us wanting COT for MSK pain and saying their addiction test is "negative"; does nothing to change the fact there's no data to support it. And for the particularly persistent, we can remind them this how fallible this test is and that there's still a very real chance they could become addicted to an opioid.
If high genetic risk 18x more likely to develop oud. Uses machine learning so supposed to improve with larger sample.
App are doing lots of this prescribing with variable oversight. Would be useful as part of their decision tree on risk mitigation. Not a get out of jail free card. More objective than a self report measure.
App are doing lots of this prescribing with variable oversight. Would be useful as part of their decision tree on risk mitigation. Not a get out of jail free card. More objective than a self report measure.
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Why is it that the fancy genetic screens for drugs are opioid-oriented and not say, what’s the best statin for someone to be on? I feel like anything tied specifically to opioids has a faint stink to it, especially when this test will probably be charged for a huge chunk of money.
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Hm. Does he have to break into the lab, delete the hard drive and fight some Russians on the way out?
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I don’t understand the purpose.
“Ok, you are going to be scheduled for ACL repair. Let’s do this test. Oops, you failed. No post op meds for you.”
“Ok, you are going to be scheduled for ACL repair. Let’s do this test. Oops, you failed. No post op meds for you.”
The Scarlett letter was actually with Demi and Gary oldman..good movie good acting
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Is Lizzo that really fat chic, oh wait I’m body shaming again
Possibly explore more nonsurgical options, increased indication for post op block, shorter duration of script, more frequent follow ups, more adjuvants, lower threshold for referral to pain or addiction if asking for more meds than usual after surgery. More thorough consent for patient regarding risks or procedure.
OUD is a disease. If you have a Factor 5 leiden there are steps to take to mitigate clot risk peri-operatively. Patient should know this genetic predisposition and helps inform their consent.
Mitigation.
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It's a disease, but everybody, including many doctors, including many pain doctors, still regard it as being a moral or character failing, and it has a large associated stigma. I wouldn't want to get the test done either
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i have already had several people bring in testing that shows that they are fast metabolizers so they need higher doses of opioids and need higher doses. what Tennant was pushing.
btw, the website implies that they were not ready for this ruling. no product available.
Home - AvertD
avertdtest.com
based on that website, here are the genetic markers they are testing for:
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I get a lot of these tests included in paperwork from the DEA. The tests are negative but the doc and patient still use them to attempt to justofy oxy 30 #180.i have already had several people bring in testing that shows that they are fast metabolizers so they need higher doses of opioids and need higher doses. what Tennant was pushing.
btw, the website implies that they were not ready for this ruling. no product available.
Home - AvertD
based on that website, here are the genetic markers they are testing for:
View attachment 380015
Prop guys are academic light weight zealots and I have a zero opioid practice. Never heard of a fda approval being rescinded but they got their names in paper which is most important.
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No but he does get his eyeballs surgically removed IIRC so he can break into the lab
