Opioids: Unique NJ Study of Genetic and Other Links to Addiction

Lilo H. Stainton | November 30, 2018 | Health Care
Trying to better understand the scourge and help identify new prevention strategies as more than 3,000 opioid-related deaths anticipated in New Jersey this year

Credit: Coriell Institute
A pioneering Camden-based research institute has partnered with academic and healthcare leaders to launch a unique study on how genetics and other factors impact opioid addiction, an effort to better understand the disease and help identify new prevention strategies.

The Coriell Institute for Medical Research announced Thursday it has joined forces with Cooper University Health Care and the Cooper Medical School of Rowan University to launch the research initiative, believed to be the first of its kind in New Jersey. Coriell is an expert in collecting and studying biologic material; Cooper provides clinical expertise and treatment input; and the medical school has research expertise in addiction and genetics, according to organizers.

Officials at Coriell, which has been a leader in biological research since the 1950s, said the project will involve taking blood and tissue samples from individuals who have died of opioid-related causes, and additional cultures from willing family members, in an effort to identify genetic connections. A biological library will also be compiled for future research.

Genetic testing will also be conducted on patients in treatment for various forms of opioid addiction and dependence, and on pain patients being treated with prescription opioids by their physicians in an effort to better understand what triggers actual addiction, the group said. All information will be used anonymously.

‘Potential to define risk factors’

“Like the rest of the nation, New Jersey faces an opioid crisis,” noted Dr. Annette Reboli, dean of the medical school. “This initiative has the potential to define risk factors for opioid addiction and develop strategies to prevent people from developing opioid use disorder and to thereby save lives.”

“This collaboration is perhaps one of the most important we could undertake for the health of so many at-risk individuals,” Reboli said.

The project is funded by a three-year $3 million state grant that dates back to the end of the former Gov. Christie’s administration, according to state Treasury officials, although it may be subject to annual approval as part of the budget process, details of which were not available yesterday afternoon. Project leaders may seek additional funding from outside sources in the future, they said.

More than 3,000 New Jersey residents are expected to die this year as a result of issues related primarily to addiction to heroin, fentanyl and other opiates, state data shows. While the number of opioid prescriptions has dipped significantly in recent years — in part because of new national clinical guidelines and state laws limiting the amount of legal drugs readily available — deaths have continued to climb, in part because of the increasing presence of the more dangerous synthetic fentanyl.

While research has identified patterns of addiction in multiple generations, this is considered a result of genetics and other factors, like an individual’s home environment, according to the National Institutes of Health. Studies have also linked a particular “opioid receptor” in the brain to a certain gene, and variations on that gene impact how an individual tolerates pain, among other things, the NIH said.

The Coriell project, dubbed CORI, for the Camden Opioid Research Initiative, will engage the state and county medical examiners to create a new “biobank” of tissue and blood samples from individuals who have died of opioid-related issues. The group will also seek to sample family members and the material and analyze the connections to determine genetic and non-genetic influences on addiction, officials said.

Examining shift from dependence to addiction

In addition, the project will involve the genetic sequencing of participants from different backgrounds, as well as several patient studies. One will focus on those now using prescribed opioids to address their pain, with the goal of determining what factors make a patient more or less likely to shift from dependence on these medications to full-blown addiction, the group said.

The other study will involve patients in substance-use disorder treatment through Cooper’s Addiction Medicine program. This seeks, among other things, to identify what role genes might plan in calibrating clinical treatments, like medication-assisted therapies involving low-level opioids to block addictive behavior, and who is most likely to succeed from such approaches, according to those involved.

“While Cooper has designed innovative clinical programs to combat opioid addiction, we believe this research will lead to the development of new weapons to aid our clinicians in the fight against this costly epidemic,” said Dr. Anthony J. Mazzarelli, co-president of Cooper University Health Care.

All three institutions will contribute staff and experience, project leaders said. They expect several dozen people to work on CORI initially. The initiative was the dream of Coriell’s late president and CEO, Michael Christman, who died late last year before it came to fruition.

“Scientifically and geographically, this team is uniquely well positioned to undertake this effort,” said Alissa Resch, Coriell’s chief scientific officer. “The knowledge gleaned from this work has the potential to save New Jersey families from the tragedy of opioid use disorder.”