By A team of Yale researchers has refined a prediction model for opioid dependence risk by combining genetic and environmental factors. The study, published in Psychological Medicine, could help physicians identify patients who are more vulnerable to opioid misuse and addiction.
Opioid dependence, also known as opioid use disorder (OUD), is a chronic condition that affects millions of people worldwide. OUD is characterized by a compulsive use of opioids, such as heroin or prescription painkillers, despite harmful consequences. OUD can lead to overdose, death, and various health and social problems.
The risk of developing OUD depends on multiple factors, such as genetics, psychology, and social environment. However, the relative contribution and interaction of these factors are not well understood. Previous studies have identified some genetic variants and environmental factors that are associated with OUD, but they have not been able to predict OUD risk accurately.
Yale Researchers Combine Genetic and Environmental Predictors
To improve the prediction model for OUD risk, a team of Yale researchers, led by Peter Na and Joseph Deak, analyzed data from 1,958 participants who were part of a larger study on substance use genetics. The researchers used a polygenic risk score (PRS), which is a measure of the cumulative effect of multiple genetic variants, to estimate the genetic risk for OUD. They also used a range of environmental and psychosocial factors, such as income, education, childhood trauma, and psychiatric diagnoses, to estimate the environmental risk for OUD.
The researchers found that the PRS alone explained only 8% of the variance in OUD, which means that it was a weak predictor of OUD risk. However, when they added the environmental factors, the prediction model improved significantly, explaining 28% of the variance in OUD. The researchers also found that some environmental factors, such as low income and low education, had a stronger effect on OUD risk than the PRS.
Yale Researchers Provide Implications for Clinical Practice and Policy
The study by the Yale researchers has several implications for clinical practice and policy. First, it suggests that physicians should consider both genetic and environmental factors when prescribing opioids to patients, as some patients may be more susceptible to OUD than others. Second, it suggests that interventions and policies that target the modification of environmental factors, such as improving socioeconomic conditions and providing mental health services, may help prevent and treat OUD. Third, it suggests that further research is needed to understand the complex interplay between genetic and environmental factors in OUD, as well as to develop more accurate and useful prediction models.
The study was funded by the National Institutes of Health and the U.S. Department of Veterans Affairs. The senior author of the study was Joel Gelernter, a professor of psychiatry at Yale School of Medicine.