Pharmacogenetic determinants of opioid addiction maintenance treatment with
buprenorphine in a Caribbean Hispanic Population
Abstract: The opioid use disorder epidemic resulted in over 60,000 overdose deaths in the
United States in 2017. Currently guidelines recommend a combination of pharmacologic
maintenance treatment (usually with methadone or buprenorphine) and psychosocial
treatment. Recently, the use of buprenorphine for opioid use disorder has increased
dramatically, partly due to fewer barriers to administration when compared to methadone.
Nonetheless, variability in patient response to buprenorphine may lead some patients to fail
treatment. In addition to clinical characteristics such as sex and concurrent medications that
affect patient variability in response to buprenorphine, genetic variability may be a factor in
the complex phenotype of therapeutic response to pharmacotherapy for opioid addiction.
Although specific pharmacogenes (OPRM1, OPRD1, UGT2B7, and CYP3A4) have been
identified that may contribute to the response of buprenorphine, there is a paucity of data in
Hispanic populations. This addressable oversight is of great concern, since it will tend to
exacerbate existing healthcare disparities that already exist affecting Hispanics with regards
to the treatment of addiction.This pilot project aims to better understand the
pharmacogenetic variables which affect the individual patient’s clinical response to
buprenorphine for the treatment of opioid use disorder. By measuring buprenorphine plasma
levels and clinical indicators of treatment response, we will perform a candidate gene
association study to better understand how relevant pharmacogenes affect outcomes in a
Caribbean Hispanic population being treated for opioid use disorder. The long-term goal of
this research is to develop Caribbean Hispanic-oriented DNA-guided approach to treatment
for opioid use disorder.