Date of Award

2018-01-01

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

Advisor(s)

Delfina C. Domínguez,

Abstract

An estimated 100 million Americans suffer from some form of chronic pain. Chronic opioid therapy (COT) use in non-malignant chronic pain patients (NMCPP) has markedly increased over the past two decades due to growing consensus that COT is suitable for the treatment of moderate-to-severe non-malignant chronic pain. Yet, COT for NMCPP has been widely associated with multiple aberrant drug-related behaviors (ADRB) such as misuse, abuse, diversion, addiction, and pseudoaddiction. One reason for the relative high incidence of ADRB among NMCPP on COT may be genetics-induced medication response variability, which, can result in pharmacotherapy failure and/or toxicity

The present study evaluated the relationships between opioid metabolizer status (OMS) (caused by inter-personal genetic variability in opioid metabolism) and ADRB such as illicit substance abuse and prescription opioid misuse. Pharmacogenetic testing (PGT) was used to categorize patient OMS, whereas urine drug testing (UDT) identified relevant ADRB. To test the study's hypoThesis, retrospective categorical data from an assembled cohort of NMCPP on COT was retrieved from a Pain Management Clinic's electronic medical records system (EMR). PGT and UDT results were cross-tabulated and analyzed with the Pearson Chi-square test for difference in proportions. Confounding and effect modification were dealt with by the inclusion of suspect variables Race/Ethnicity and Sex in a logistic regression model.

The results of the study showed that there was no statistically significant association between opioid metabolizer status and aberrant drug-related behaviors nor between the two suspect confounding variables and aberrant drug-related behaviors.

Language

en

Provenance

Received from ProQuest

File Size

115 pages

File Format

application/pdf

Rights Holder

Eduardo Aguila

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