Drug Treatment Success Begins With Genes

Drug Treatment Success Begins With Genes

When it comes to treating drug addiction, genetics can play a major role. The genetic factor hasn’t been used in treatment plans, but that’s changing with pharmacogenetic testing that recently was approved by Medicaid and rolled out as a nationwide program.

The test is simple: just a swab from both of the patient’s cheeks. In three to five days, a drug treatment center receives a report listing what medications the patient can and cannot metabolize. In other words, the genetic report reveals which medications would have no effect on that particular patient, no matter how large the dose.

Mark Benviniste
Mark Benveniste

In addition, the test can determine the likelihood of that person to turn to alcohol, nicotine or sugar as secondary addictions, as well as possible side effects, such as weight gain.

The test is easy to interpret. A green circle means the patient can metabolize the medication. A caution triangle means to proceed with caution because the patient may have an increased risk of side effects or has a poor response to the medication. A red circle means the patient cannot metabolize the medication.

Currently, doctors focus on either the physical or the physiological side of drug addiction.

But “it’s both,” said Mark Benveniste, the director of operations of Atlanta-based Readmissions Reduction Group, which created the pharmacogenetic testing. The RRG approach “is way advanced. It’s amazing. We swab them upon admission, and within a couple days they can use this as a playbook to prescribe the exact medication.”

He said half the people who take medications do not metabolize them. “We tell them not predictively, but exactly which chemicals their body will respond to.”

That information will help doctors treat patients more accurately from the beginning and should reduce the incidence of relapse, which can occur when patients don’t absorb and respond to medicine. Benveniste said a study by the University of Massachusetts Medical School of 52,000 people being treated for drug addiction found that the use of proper medication for each person cut the relapse rate in half.

“Addiction is not an acute illness that is treated in a short time,” Benveniste said. “It’s a real disease.”

Although Benveniste’s organization has worked on creating the addiction panel test since December, it took until the summer to get approval for coverage by Medicaid. The test also is approved by many private insurance companies.

The protocol has been tested at Valley Vista, an inpatient alcohol and chemical dependency treatment center in Bradford, Vt., where Benveniste said the results were phenomenal. Officials at Valley Vista did not return a phone call seeking comment.

RRG “did a number of tests with them to make sure their medical director was happy with it, our medical director was happy, and state Medicaid realized it’s in their financial best interest,” Benveniste said.

The protocol also was one of 40 national semifinalists for ABL’s Innovations in Healthcare ABBY Awards but didn’t make the list of nine finalists announced Aug. 23.

Not only can the test be used to help treat drug addiction, but people also can be tested at their doctors’ offices to see which medications they take truly work for them. If necessary, the results include options for other medicines.

Doctors must be participants with Readmissions Reduction Group to perform the test. On the last page of the clinical report is a card that can be laminated and kept in the patient’s wallet to show future doctors and pharmacists.

You need the test only once in your lifetime because genes never change, Benveniste said.

Now that the testing is available nationwide, Readmissions Reduction Group anticipates being contacted by facilities across the country.

“I think the biggest influx we’re going to have is clinically from medical directors,” Benveniste said. “Their level of frustration in trying to figure out what to give somebody who comes in off the street is reaching an all-time high. At the root of it all is your genes. It’s a game-changer.”

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