Future Newborns with Opioid-Induced Neonatal Abstinence Syndrome (NAS) Could Be Assessed with the Genetic Addiction Risk Severity (GARS) Test and Potentially Treated Using Precision Amino-Acid Enkephalinase Inhibition Therapy (KB220) As a Frontline...

Overview

Journal J Pers Med

Date 2022 Dec 23

PMID 36556236

Authors

Mauro Ceccanti

Kenneth Blum

Abdalla Bowirrat

Catherine A Dennen

Eric R Braverman

David Baron

Thomas Mclaughlin

John Giordano

Ashim Gupta

Bernard W Downs

Debasis Bagchi

Debmalya Barh

Igor Elman

Panayotis K Thanos

Rajendra D Badgaiyan

Drew Edwards

Mark S Gold

Affiliations

Soon will be listed here.

Abstract

In this nonsystematic review and opinion, including articles primarily selected from PubMed, we examine the pharmacological and nonpharmacological treatments of neonatal abstinence syndrome (NAS) in order to craft a reasonable opinion to help forge a paradigm shift in the treatment and prevention of primarily opioid-induced NAS. Newborns of individuals who use illicit and licit substances during pregnancy are at risk for withdrawal, also known as NAS. In the US, the reported prevalence of NAS has increased from 4.0 per 1000 hospital births in 2010 to 7.3 per 1000 hospital births in 2017, which is an 82% increase. The management of NAS is varied and involves a combination of nonpharmacologic and pharmacologic therapy. The preferred first-line pharmacological treatment for NAS is opioid therapy, specifically morphine, and the goal is the short-term improvement in NAS symptomatology. Nonpharmacological therapies are individualized and typically focus on general care measures, the newborn-parent/caregiver relationship, the environment, and feeding. When used appropriately, nonpharmacologic therapies can help newborns with NAS avoid or reduce the amount of pharmacologic therapy required and the length of hospitalization. In addition, genetic polymorphisms of the catechol-o-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes appear to affect the length of stay and the need for pharmacotherapy in newborns with prenatal opioid exposure. Therefore, based on this extensive literature and additional research, this team of coauthors suggests that, in the future, in addition to the current nonpharmacological therapies, patients with opioid-induced NAS should undergo genetic assessment (i.e., the genetic addiction risk severity (GARS) test), which can subsequently be used to guide DNA-directed precision amino-acid enkephalinase inhibition (KB220) therapy as a frontline modality instead of potent opioids.

Citing Articles

Solving the Global Opioid Crisis: Incorporating Genetic Addiction Risk Assessment with Personalized Dopaminergic Homeostatic Therapy and Awareness Integration Therapy.

Zeine F, Jafari N, Baron D, Bowirrat A, Pinhasov A, Norling B J Addict Psychiatry. 2024; 8(1):50-95.

PMID: 39635461 PMC: 11615735.

Eat, Sleep, Console model for neonatal opioid withdrawal syndrome: a meta-analysis.

Chu L, Liu X, Xu C Front Pediatr. 2024; 12:1416383.

PMID: 39220152 PMC: 11362100. DOI: 10.3389/fped.2024.1416383.

Are We Getting High Cause the Thrill is Gone?.

Blum K, Mclaughlin T, Gold M, Gondre-Lewis M, Thanos P, Elman I J Addict Psychiatry. 2024; 7(1):5-516.

PMID: 38164471 PMC: 10758019.

Beyond Mor: Can Induction of Dopamine Homeostasis Along with Electrotherapy Attenuate the Opioid Crisis?.

Blum K, Bowirrat A, Braverman E, Dennen C, Zeine F, Jafari N Clin Exp Psychol. 2023; 9(2):1-3.

PMID: 37363693 PMC: 10288571.

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