SOLVD Health
Why You (and Your Doctor) Should #KnowYourRisk for Opioid Addiction

Why You (and Your Doctor) Should #KnowYourRisk for Opioid Addiction

by | Oct 7, 2021 | Genetics, Opioid Crisis

Opioids are effective at managing moderate to severe pain and are often prescribed following surgery or injury—but they come with a risk of addiction. While everyone who takes prescription opioids is at risk for addiction, that risk is higher for some people than others.

Because treating acute pain (pain lasting less than 30 days) safely and effectively is a priority for both you and your provider, it’s important to understand your personal risk for addiction before oral opioids like oxycodone and hydrocodone are ever prescribed.

A Gateway to Addiction

While there are many entry points for opioid abuse and addiction, prescription opioids continue to play a significant role, with nearly 80% of heroin users reporting that they first misused prescription opioids prior to heroin.1

Surgical care is one gateway to addiction: An estimated 67 million opioid prescriptions are written each year in the U.S. by surgically-focused specialties,2 potentially leading to as many as 7 million additional Americans misusing or becoming addicted to opioids annually.3

Even short-term opioid use can lead to addiction and, too often, overdose. Research has shown that your odds of still taking opioids a year after starting a short course increases after only five days of taking them.4 Another study found that each year, 6% of patients prescribed oral opioids for post-surgical pain were still taking opioids three to six months after surgery.5

And the consequences of opioid addiction are dire: In 2020, more than 93,000 people died from drug overdoses—the highest number of overdose deaths ever recorded—and almost 75% of these deaths were opioid-related.6

Risk Factors for Opioid Use Disorder

There are many known factors associated with increased risk for opioid addiction (also called Opioid Use Disorder, or OUD). They include psychological factors, such as childhood trauma or mental health conditions like anxiety or depression; environmental factors, such as growing up or living in high-stress environments; and biological factors, such as family or personal history of substance abuse.7

To account for these factors, your physician will review your medical history, conduct a complete clinical evaluation, and may have you complete a risk questionnaire. It’s important to be as honest and thorough as you can when providing information to your doctor.

Another key factor is your genetics, which research has shown can account for up to 70% of overall risk.8 However, until recently, physicians and their patients didn’t have an objective way to assess genetic risk for OUD. But thanks to recent scientific advances, genetic risk assessment is now available.

Designed for More Informed Decisions

AvertD is a clinically validated test that identifies an individual’s genetic risk for developing OUD. The test requires only a simple cheek swab sample and analyzes 15 genetic markers involved in the brain reward pathways associated with addiction to identify if a patient is at high or low risk for OUD.

When use of prescription oral opioids for acute pain is being considered, AvertD offers an objective way to identify who may be at increased genetic risk for opioid addiction—so you and your provider can make more informed clinical decisions about how to manage your pain safely and effectively.

Because genetics are only one factor in understanding the risk of developing OUD from using oral opioids, AvertD test results should always be used in conjunction with a complete clinical evaluation to determine the appropriateness of oral opioids for pain management.

Want to #KnowYourRisk? Learn more at https://avertdtest.com/

References:

1Opioid Overdose Crisis. National Institute on Drug Abuse. Available online at: https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

2Stark N, Kerr S, Stevens J. Prevalence and predictors of persistent post-surgical opioid use: a prospective observational cohort study. Anaesth Intensive Care. 2017;45(6):700-706. doi:10.1177/0310057X1704500609

3Guy G, Zhang K. Opioid prescribing by specialty and volume in the US. Am J Prev Med. 2018; 55(5):e153-e155

4How opioid addiction occurs. Mayo Clinic. Available online at https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372

5Brummett, et al. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg. 2017;152(6):e170504. doi:10.1001/jamasurg.2017.0504.

6Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2021. Accessed at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm on July 26, 2021.

7St Marie B. Assessing Patients’ Risk for Opioid Use Disorder. AACN Adv Crit Care. 2019;30(4):343-352. doi:10.4037/aacnacc2019931

8Bevilacqua L, Goldman D. Genes and addictions. Clin Pharmacol Ther. 2009; 85(4):359–361. doi:10.1038/clpt.2009.6

COVID-19 is Worsening the Opioid Epidemic

COVID-19 is Worsening the Opioid Epidemic

by | Dec 16, 2020 | Opioid Crisis

As the United States continues to battle the national public health crisis presented by the COVID-19 global pandemic, our nation’s ongoing opioid epidemic is worsening.

To date there have been more than 17 million confirmed cases of COVID-19 in the U.S., and more than 310,000 deaths. In addition to high infection rates and the devastating death toll, the secondary health repercussions of the pandemic have been profound. Increased stress, economic hardship, social isolation, and disruption to healthcare services, among others, have presented significant challenges for many Americans, but perhaps even more so for those battling substance use disorders, including opioid addiction.

Drug Overdoses are Increasing Dramatically

According to the Substance Abuse and Mental Health Services Administration, more than 20 million Americans struggle with a substance use disorder. Based on provisional data from the Centers for Disease Control (CDC), nearly 72,000 Americans died of drug overdoses in 2019, nearing record numbers.

During the first three months of 2020, drug overdose fatalities increased by roughly 10%, according to preliminary numbers from the CDC. If this trend continues, the CDC estimates there will be more than 75,000 drug-related deaths in 2020, which would set a grim record for the second consecutive year.

Compared to the same time periods in 2019, the Overdose Detection Mapping Application Program, a federal initiative that collects data from ambulance teams, hospitals, and police, found that overdose deaths jumped 18% in March, 29% in April, and 42% in May.

When looking at opioid-related deaths specifically, more than 40 states have reported increases in opioid-related fatalities since the COVID-19 pandemic began.

Stress is Taking a Toll on Our Mental Health

According to a CDC survey conducted in June, 13% of U.S. adults said they had started or increased substance use to deal with the stress of COVID-19. In addition, the percentage of Americans reporting symptoms of depression has more than tripled during the coronavirus pandemic.

Due to social distancing guidelines, many Americans are finding themselves increasingly isolated from family, friends, and other support networks, and it is harder for loved ones who don’t live together to physically check in on each other. Because addiction is a disease of uncertainty, isolation, and anxiety, all of these issues can negatively affect people with substance use disorders.

Record-High Unemployment is Creating Economic Distress

In April, the U.S. economy lost 20.5 million jobs, the largest and most sudden decline since the government began tracking the data in 1939, and the unemployment rate soared to 14.7%.

Every 1% hike in the unemployment rate will likely produce a 3.3% increase in drug-overdose deaths and a 0.99% increase in suicides, according to data from the National Bureau of Economic Research and the medical journal The Lancet.

Unemployment, furloughs, salary cuts, loss of health insurance, and other consequences of economic hardship can all contribute to stress, depression, anxiety, and loss of access to healthcare, putting people with substance use disorders at greater risk for relapse and/or overdose.

Access to Treatment & Support Has Been Disrupted

The social isolation imposed by the COVID-19 pandemic hasn’t just interrupted our personal connections with family and friends but has also disrupted access to services for people with mental illness and substance use disorders. These services include doctor’s visits, treatment, counseling, 12-step programs and other addiction support groups, residential programs, and more, leaving huge gaps in the safety net that many people with substance use disorders depend on.

To combat this disruption, many services have transitioned to being delivered online or via telemedicine. In addition, federal and state agencies are realizing the downstream impact of these disruptions in care, and at the federal level, new legislation is being introduced to help people access treatment and recovery programs, including reimbursing telehealth visits and changing in-person prescribing to virtual/remote. However, some services, such as support groups, are hard to replicate on Zoom and also require reliable internet access, which not everyone has. We also don’t yet know how telemedicine may be changing providers’ prescribing patterns.

People with Substance Use Disorders are at Increased Risk for COVID-19

A National Institutes of Health-funded study published September 14 found that people with addiction disorders are at greater risk for COVID-19, and if infected, more likely to be hospitalized or die. This is due, at least in part, to the fact that many substance users have preexisting conditions that would worsen their prognosis. The effect was strongest among those with opioid use disorder, followed by tobacco use disorder, according to the findings.

During the study, the researchers analyzed non-identifiable electronic health records of more than 73 million patients in the U.S. They found that people with addiction disorders accounted for just over 10% of those in the study, but nearly 16% of COVID-19 cases.

In addition, because people with addiction are often already marginalized, it can be even harder for them to access healthcare services when they need them.

Treatment and Prevention are Key to Managing Both Crises

Both COVID-19 and the opioid epidemic are public health problems that require public health solutions. The first part of the solution is making sure we can treat these conditions. For COVID-19, that means having enough hospital beds, ventilators, supplies, and staff to treat sick patients. For opioid use disorder, it’s making sure that people have access to care, treatment programs, medications, and support.

The second part of the solution is prevention. As the COVID-19 pandemic has continued, there have been national discussions around increased testing, increased surveillance, contact tracing, mask mandates, and recently, vaccines have started to become available. For opioid use disorder, the key to prevention is to better understand who is most at risk for opioid addiction and then taking action to prevent it. If personalized risk information is available, affordable, and accessible, then the patient and their provider can make more informed decisions about pain management before that first opioid prescription is ever written.

SOLVD Health is Helping Combat the Opioid Crisis

At SOLVD Health, we’re working to develop and commercialize a potentially groundbreaking genetic test designed to assess a patient’s risk of opioid use disorder prior to receiving oral opioids for short durations, including after procedures such as elective or non-emergent surgeries. Our decision to develop this test was a direct response to the human cost we are seeing in communities across the United States.

Currently, providers often don’t have enough contextual, relevant, and objective information about the patient to identify those at high risk for opioid addiction before it occurs. We believe that unlocking this type of information and identifying individuals who may be at increased risk for opioid use disorder could prevent addiction, save lives, and make a significant impact on curbing the opioid epidemic.