Craig Stevens, a professor of pharmacology at Oklahoma State University, submitted a proposal to prevent opioid overdose deaths by “turning off” a specific receptor for opioids in the brain using scientific technology known as CRISPR.  CRISPR stands for clustered regularly interspaced short palindromic repeats.Stevens published his notion in a peer-reviewed article for the Journal of Neuroscience Research.  In the writeup, Stevens shows how an individual’s genetic composition can be altered by injecting CRISPR molecules into the brain via “a new neurosurgical microinjection technique.”  The molecules would “render the mu opioid receptor nonfunctional in specific neurons.”  This theory was tested in mice and found it did, in fact, limit slowed breathing and, thus, reduced death by overdose.  In August of this year, scientists at the Chinese Academy of Sciences in Shanghai also published a pre-print showing how CRISPR technology can mutate specific genes in monkeys.“Yes, CRISPR-based therapies could technically be delivered in vivo to specifically delete a gene in the human brain,” said Randall Platt, an assistant professor at ETH Zurich, in Switzerland.  But, he added, “substantial work on the clinical development front needs to be done before this would be advisable.”  Platt warned that unintended changes in the subject’s genome can occur and said, “There is absolutely no way to avoid these with 100% certainty.”

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Another piece of the puzzle to consider is that while CRISPR may be able to change genetic code, it does not address society’s shortcomings in addressing addiction issues, in general.  With no opioid receptors on respiratory neurons, users cannot die from opioid overdose.  However, this does not solve the underlying causes of addictive behavior or help remedy treatment funding issues.“The U.S. spends just 2.5% of its healthcare budget on public health.  But the NIH, in 2016, spent more than half of its $26 billion budget on research directly linked to search terms that include gene, genome, stem cells or regenerative medicine,” according to Erik Parens, a senior research scholar at The Hastings Center.Lisa Parker, the director of the Center for Bioethics & Health Law at the University of Pittsburgh, added, “What I’m working on is more social interventions.  My own view is that, for most health-related issues, intervening in social factors is often a better approach, or the first approach, to attempt prior to intervening in the genome.”  She is advocating for changes at the societal level, rather than the individual level, adding, “I think it is an example of a tendency that we have to look to individuals, and to individual level risks and individual level solutions, rather than looking to the messier, more-complicated social level.  We have a lot of things that we know work to reduce risk of death from overdose, reduce overdoses, and reduce opioid addiction.  We just aren’t adequately doing them.”In short, CRISPR may be a viable solution for maintenance of substance use disorder and opioid use disorder but it is a more reactive approach than a proactive one.  If you or someone you know is struggling with drug addiction, contact the National Drug Helpline at 844-289-0879, resources@drughelpline.org.

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A proposal to use CRISPR to prevent opioid overdoses is classic useless American healthcareHow gene editing a person’s brain cells could be used to curb the opioid epidemic