The OPRD1 rs678849 variant influences outcome of disulfiram treatment for cocaine dependency in methadone-maintained patients

Psychiatr Genet. 2021 Jun 1;31(3):88-94. doi: 10.1097/YPG.0000000000000279.

Abstract

Objective: Prior research demonstrated that the δ-opioid receptor (OPRD1) rs678849 variant influences opioid use in African Americans treated with methadone. We examined whether this variant moderated cocaine and opioid use in our clinical cohort of methadone and disulfiram treated recipients.

Methods: Cocaine and opioid codependent patients were stabilized for 2 weeks on methadone and subsequently randomized into groups treated with either methadone + placebo (n = 37) or methadone + disulfiram (250 mg/day; n = 33) for 12 weeks.

Results: A drop in cocaine-positive urine was found in the OPRD1 CC genotype group compared to T-allele carrier patients treated with methadone + disulfiram (P < 0.0001), but not in the methadone + placebo group. No difference in opioid-positive urines was found among each genotype group in either treatment group.

Conclusion: These findings suggested that rs678849 genotype may predict treatment response of disulfiram for cocaine use in patients with co-occurring opioid and cocaine dependence.

Trial registration: ClinicalTrials.gov NCT00149630.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alleles
  • Cocaine / urine
  • Cocaine-Related Disorders / drug therapy*
  • Cocaine-Related Disorders / genetics*
  • Disulfiram / therapeutic use
  • Female
  • Genotype
  • Humans
  • Male
  • Methadone / therapeutic use
  • Middle Aged
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / genetics*
  • Receptors, Opioid, delta / genetics*
  • Treatment Outcome

Substances

  • OPRD1 protein, human
  • Receptors, Opioid, delta
  • Cocaine
  • Disulfiram
  • Methadone

Associated data

  • ClinicalTrials.gov/NCT00149630