Opioids can be angels or devils. When used properly, these medications can provide relief from severe acute pain, such as what you could experience after a surgery or from cancer. However, opioids can also have devastating consequences, including addiction, overdose, and death.
There are some ailments for which opioids are not a good treatment option—most notably, chronic pain (i.e. lower back pain that someone has had for years). “This is because while they are excellent analgesics, people develop tolerance quickly, so they end up needing higher and higher doses to maintain the same effect,” says Kathleen Brady, MD, PhD, Vice President of Research at the Medical University of South Carolina, and a Genomind Advisory Board Member.
This is one of the ways that opioids have the potential for abuse and the development of an addiction. “Many people get euphoric from opioids and end up taking more than prescribed, for longer periods than they are prescribed for, so it is particularly important to take exactly as directed and for as short a period of time as possible,” she says.
What Determines Opioid Addiction
Becoming addicted to opioids isn’t a given. Most patients don’t set out to misuse or abuse opioids, but between 8% and 12% of patients will go on to develop an opioid use disorder, according to the National Institute on Drug Abuse.
How your body metabolizes opioids plays a role in whether they will have a pain-relieving effect, or induce a toxicity. Opioids are cleared through the body the same way all medications are—through a process of absorption, distribution, metabolism, and elimination. Learn what everyone needs to know about drug metabolism. Understanding how your body may process opioids can help decrease your risk for opioid harm.
Here’s what you should know before taking an opioid
How opioids are metabolized
Most drugs, including many opioids, are metabolized through a family of enzymes in the liver called cytochrome P450 system (CYP450). The opioids that are metabolized by CYP450, for instance, include codeine, hydrocodone, oxycodone, methadone, tramadol, and fentanyl. So when they are taken along with other drugs that are also mediated by the same pathways, there is the potential for a dangerous interaction, Dr. Brady explains.
Whether you have variations of these enzymes as part of your genetic makeup can be revealed through pharmacogenetic testing, such as Genomind’s. The results of this test can help your doctor determine how your body metabolizes medications that involve CYP450 enzymes. Genomind can provide you and your doctor with this information, which we call your Patient Metabolism Card, to help inform choices of medication and dosing. Learn more about how Genomind could help personalize your treatment plan.