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UNLV Professor On How Tailor-Made Drugs Could Address The State's Opioid Crisis

Nevada has long struggled to help people with mental illnesses and the state, like many areas of the country, is struggling with the opioid crisis. But could both of those problems be addressed with technology from the 50s?

In the 1950's, researchers began exploring the field of pharmacogenetics. 

It's the science of how our body's genes and drugs interact – and how well the body breaks down and absorbs certain drugs.

The medical potential is that it could end a one-dose-fits model for medical prescriptions. Instead, drugs would be personalized, based on a patient’s individual genetic makeup.

But 60 years after it became known, pharmacogenetics is still not widely used in medicine. Roughly 12 percent of all doctors use it, according to a recent study.

Jay Tan, an assistant nursing professor at UNLV and a nurse practitioner, has an idea of why it's so sparsely used. 

“I think the problem is it’s still not part of a big curriculum for any medical training or even in nurse practitioner training,” he said.

Tan told KNPR's State of Nevada that while many practitioners know it works they don't use it because they're simply unfamiliar with it.

According to Tan, to use pharmacogenetics, doctors would need to swab the inside of a person's mouth to collect genetic material. That genetic material can then be analyzed to show what medications would work the best. 

For example, the genetic testing will show if a person metabolizes a medication quickly or slowly. That information could determine how much of a medication is needed, Tan said. If someone metabolizes a medication quickly, he or she may need a higher dose to get the same result.

“Pharmacogenetics is the science that gives us that predictability if that medication really fits your body,” he said.

Tan said the technology started with cancer patients but it is also very useful with pain medication because it allows doctors to specifically target pain instead of using a series of medications that provide too much or not the right kind of medication for a patient's pain. 

The same is true of people with mental illnesses. Tan, who is a nurse practitioner specializing in mental illness, used pharmacogenetics to determine the proper medication for a patient. He said the patient went from hearing voices to no delusions. Eventually, she was able to go back to work. 

Besides doctors not feeling comfortable with the science, Tan said people don't choose to get it done because many health insurance companies don't cover it. But he believes that pharmacogenetics can benefit everyone and take the guess work out of prescriptions. 

Jay Tan, assistant nursing professor, UNLV

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