Grant: Project Grant

Opioids are commonly used medications for pain but have very high liability for misuse and addiction. There are also street opioids such heroin and the deadly fentanyl and carfentanil. Canada is the second highest opioid consumer in the world and is facing a public health crisis with opioid addiction (opioid use disorder (OUD)) and death. There are relatively few treatment options for OUD and the most common is a substitution with methadone (methadone maintenance treatment, MMT), a synthetic opioid. However, MMT outcomes vary greatly, with the average patient receiving MMT for multiple years and many continuing to use opioids while on MMT. Furthermore, MMT itself carries significant health risks, including high rates of death. There is preliminary evidence that differences in MMT response are partially determined by the individual genetic makeup. Identifying how genes affect the response to methadone has the potential to substantially improve the opioid addiction treatment outcomes via a precision medicine approach. Toward this end, the proposed study will leverage innovations in genomic approaches to systematically examine individual variation in MMT response in a large sample of opioid addiction MMT patients. Our hypothesis is that MMT outcomes are significantly determined by genes that can inform future treatment decisions and the study's fundamental goal is to rigorously test this hypothesis using multiple cutting edge methodologies.