Addiction Labs: Pharmacogenetic & Toxicology Testing
What Sets Us Apart?
AAC’s utilization of an addiction-focused laboratory sets American Addiction Centers apart from most addiction treatment centers. Addiction Labs of America is a high-tech laboratory that caters to the unique testing and monitoring challenges of addiction treatment.
Addiction Labs prides itself on excellent service, speed, and accuracy. AAC’s medical and psychiatric providers can easily consult with toxicology experts about laboratory results, enabling thorough understanding and interpretation. Addiction Labs has industry-leading turnaround times and adheres to strict quality control protocols to ensure that results are quick and accurate.
The testing menu at Addiction Labs includes:
What is pharmacogenetics?
Different drugs are metabolized, or processed, through different pathways in the body and involve different enzymes. The ability of the body to metabolize a medication will vary from person to person according to each individual’s DNA. Pharmacogenetics refers to the study of how a person’s inherited genetics influence their response to a drug.
Why does this matter?
Common variations in genetics lead to differences in the ways medications affect individuals. Our genetic makeup influences the method by which medications are absorbed, distributed, metabolized, and eliminated from the body. Several genes have been identified that specifically influence individual drug-metabolizing enzymes in the liver.
These variations can mean that people will sometimes react very differently to the same dose of the same drug, with one person receiving an inadequate dose and another afflicted with toxicity. Pharmacogenetics helps prescribers identify medications that are more likely to cause side effects or are more likely to be ineffective, reducing trial and error and helping them find the right medication for that patient more quickly.
People with substance use disorders often have accompanying physical health and mental health illnesses (also known as comorbid conditions or co-occurring illnesses). Thus, it is even more essential to find the right medication sooner, since worsening of other conditions can worsen their substance use disorder(s) and vice versa.
How common are medication failures?
Failure rates are surprisingly high with commonly prescribed medications:
- Antidepressants – 30% to 40% of people on antidepressants did not respond to the treatment
- Asthma drugs – 64% of people on inhaled corticosteroids and long-acting ?2-agonists still did not have well-controlled asthma
- Diabetes drugs – 40% of patients who started taking metformin did not have a reduction of at least 1 percent in their A1c levels
- Alzheimer’s drugs – 42%-60% of people on donepezil did not respond to the treatment
With the assistance of pharmacogenetic testing, prescribers at American Addiction Centers facilities can more quickly find the right medications for patients, whether that’s medication-assisted treatment for a patient’s substance use disorder, psychiatric medications for a patient’s mental illness, or both.
The Testing Process
A nylon-flocked swab, which looks like a long Q-tip, is rubbed on the inside of a patient’s cheek. This swab is then sent to Addiction Labs for processing. They extract the patient’s DNA from the swab and run assays which determine whether the patient has any relevant genetic variations within the genes tested.
The provider indicates which panel (set of genes) they would like the patient’s sample tested for. Options include:
Pain Panel – includes medications in categories such as:
- Opioids (natural and synthetic)
- Muscle relaxants
Psychiatry Panel – includes medications in categories such as:
- Anti-ADHD (stimulant and non-stimulant)
- Anticonvulsant (commonly used for bipolar disorder)
- Antidepressant (SSRI, SNRI, tricyclic, and atypical)
- Antipsychotic (first and second generation)
Pain and Psychiatry Panel (Comprehensive)
- Other individual panels (such as just antidepressants, just antipsychotics, etc.)
Many individuals struggling with the disease of addiction avoid going to a healthcare provider for years at a time, or only go to try to obtain their drug of choice and do not get a full exam. Many of our patients didn’t want to see a healthcare provider because they didn’t want to be confronted about their addiction. Through Addiction Labs of America, healthcare providers at AAC facilities are able to evaluate for various health concerns that may have persisted undetected or unidentified.
Routine labs, such as checking a patient’s blood sugar and cholesterol, can identify common health conditions that need treatment, or may even allow practitioners to create a plan to prevent issues from arising. For instance, diet and exercise changes can prevent an individual with prediabetes or borderline high cholesterol from needing medication in the future if these conditions were to escalate. Bloodwork can also highlight physical health concerns that may be worsening a patient’s mental health, such as low or high hormone levels that can contribute to irritability, depression, or other problems. These issues, when revealed through routine bloodwork, often have relatively simple fixes that we can use to improve a patient’s health and set him or her up for success.
As an addiction treatment center, we know that some addictions and methods of drug use can increase risk for certain illnesses. For example, alcohol use disorders increase the risk of liver cirrhosis and pancreatitis, and individuals who use drugs intravenously are at a heightened risk for HIV and hepatitis C. These conditions can be dangerous or even deadly if untreated. By routinely screening patients for conditions they are at risk for, we can identify these illnesses early and intervene early, thereby preventing complications and increasing patient’s safety and overall wellbeing.
Urinalysis guides treatment in other ways, by identifying what substances are present in a person’s system. Individuals coming in for treatment may not be able to recall all the substances they were taking, or substances may have been laced with other drugs that they did not know about. Urinalysis helps providers identify all of these and ensure that the patient gets the appropriate care to keep them safe and minimize discomfort.
For outpatient programs (OP) in particular, ongoing urinalysis testing allows staff at AAC facilities to track a patient’s substance use, ensuring that they are taking the appropriate medications and avoiding using substances other than those they are prescribed. This is not to get the patient in trouble, but rather to provide them with accountability that is beneficial in addiction treatment and to keep the provider informed so they can adjust their treatment plan if the patient is still having relapses.