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DNA SWABS

My Doctor not only had me do a drug test but he also told me i had to do a
DNA test , now i don't care about drug tests i have nothing to hide but this DNA test has really got me Angry .. I want to know if this is Legal and I want to know if this is a violation of our Constitutional right .. It is hard enough being in pain day after day and now to be Harassed like this by our pain doctors has really got me Mad ...And went i am upset my pain level gets worse .  
16 Responses
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7721494 tn?1431627964
It's in the mail.
Helpful - 0
547368 tn?1440541785
You go guy!!!  Write that app! Be sure to remember the "little ppl" at MedHelp and how they loved and encouraged you through the process.

~Tuck

PS: In the meantime can you loan me a few million while I wait?
Helpful - 0
7721494 tn?1431627964
Hi SuperXNovaX XX XX XX - BANG! Welcome to the pain forurm.

That's a good question.

From what I've seen of these reports, they report and graph your tendencies to make specific enzymes that assist your liver in metabolizing the various opiate, and synthetic opioid medication types. These have labels like CYP450 2D6. Fascinating reading.

But they also include analyses written by specialists in pharmacogenetics, a word as big as a super nova.

In these reports, include data about how these enzymes are essential to the so-called metabolic pathways for certain medications, like morphine, oxycodone, and methadone, but can also include other medications like the benzo tranquilizer group, and even antibiotics.

You see, pharmacogenetics is the new frontier of drug safety and efficacy.

Knowing what CYP450 enzymes your built to produce can predict your analgesic response to medication, and used with your list of medications, a trained pharmacologist who understands those terms -- pharmacodynamics (PD), pharmacogenetics (PG), and pharmacokinetics (PK) -- can prevent nasty drug-drug interactions.

The new frontier involves preventing severe reactions in drug allergies and minimizing unwanted side effects.

Someday, they'll take your DNA at birth, just like the do your blood type, and it will become part of your permanent medical record. With that information, the computer that manages your medical care will prescribe custom printed medications designed with your genetics in mind.

It will probably be accessed through an app on your phone.

I'm writing that app, and will one day will be richer than Bill Gates (Mr. Microsoft) , Pierre Omydar (Mr. Ebay), and Mark Zuckerberg (Mr. Facebook), combined.

$$$$$$$$$  -- the artist formerly known as philnoir
Helpful - 0
Avatar universal
What meds did the DNA test say work best for you. I just had my DNA swab today.
Helpful - 0
547368 tn?1440541785
Hi Abbey,

This DNA test just suppose to inform the PMP how well a person metabolizes different opiates. I think it could be helpful for a chronic pain patient that requires large doses of opiates - or one that is having issues finding an effective opiate.

It's just me Abby. As you can see by my responses - I just don't trust much or many in this opiate hostile environment.  If the swab DNA was used just as intended and when appropriate I may have an different opinion on it. However even my seasoned, well educated PMP states, "They don't have the bugs out yet."

My Best,
~Tuck
Helpful - 0
7721494 tn?1431627964
Abbey, there are all kinds of DNA tests available now. This is the way medicine is progressing, and for good reasons.

For example, a class of cholesterol lowering drugs called statins were all the rage in family medicine in this century, but family physicians were noticing that some of their patients were developing painful myopathies -- painful muscle pain, aches, and spasms -- developing in certain patient populations.

Discontinuing the statin stops the myopathy, but was a painful process of discovery for some, filled with misdiagnoses of fibromyalgia.

A 2007 medical paper associated certain statins with this syndrome. The enzyme, CYP2C19, responsible for metabolizing many cardiac drugs, was later discovered to be the culprit behind the statin-myopathy link.

Now primary care physicians can offer a pharmacogenetic testing for CYP2C19 in high risk patients before beginning that patient on these cholesterol reducing drugs.

And no, the government doesn't get the DNA samples collected from these patients, either.
Helpful - 0
Avatar universal
my goodness....I wish I had something intelligent to say but I am astounded! I have never even heard of this yet, but I'm sure I will soon, so I must say that it looks as if I better get researching! I see the good (maybe) in this but also see the bad to make a very simple statement. Can these tests be used for anything other than these opioid receptors? I am just speechless but want to thank all of your for all of the info you have placed on this thread! I truly never heard of this before and now know that I must get myself knowledgeable on the subject asap! Thank you all for your input!

Best Regards to all,
Abbey
Helpful - 0
547368 tn?1440541785
Phil,

I think what most ppl are frightened about is two fold, #1 they don't have a choice and #2 it's not being explained in detail and the term DNA conjures up some major privacy issues. Maybe that was three fold! :0)

When we think of DNA we don't think about a family of enzymes that only reveals how our body metabolizes different opiates.

Just as the media only seems to talk about the abuse of opiates and not the Chronic Pain Patients - they only talk about how DNA infringes upon our privacy - and the "bad ways" these results can be used against us.

Now add the expense of the DNA Swab to SS recipients or the poor that are just squeaking by - they have to pay for drug screens when they never have or never will abuse or divert their opiates - and add the cost of the actual medications and they are ticked!!! They have every right to be ticked. If they feel their moderate dose of opiate medication is effective and has been for several years why should they now have to pay the cost of this DNA swab? It makes no sense except in a select few instances.  

Ppl don't understand this test because it's not explained at length and in terms that they can understand. I've read about this at length and I still have questions - I don't mean I'm smart - I'm not - but I do have some medical education and experience.  

I understand the anger and fear.

Peace,
~Tuck
Helpful - 0
7721494 tn?1431627964
You are entitled to your opinion, but the government is not involved here.

When you get a prescription for a controlled substance filled, the government, as well as your doctor and pharmacist all have access to that data -- I don't like this either.

We're talking about a medical test that is part of your medical record. As far as I know, the government does not yet have the right to open your medical records without cause.

If it comes to that, we must protest, certainly. But for now, our medical records are private.
Helpful - 0
Avatar universal
I do not agree on this,I think the government wants to know everything about us.If a drug makes the pain go away, then thats all well,as long as you take your meds the right way.
Helpful - 0
7721494 tn?1431627964
... and you are entitled to that opinion!

I see your point, Tuck. This could be considered another unnecessary medical test. I guess it all depends how the practitioner uses it.

I believe these DNA scans can also provide clinical data to a pain doc -- if a good oxycodone metabolizer is not responding to increased doses of Percocet, it can indicated a severe pain, or a pain condition non-responsive to opioids.

If I were that pain doc, I'd want to know -- especially if a making the diagnosis is tricky.

Also, I believe there will be savings later, because you're not going to be prescribed an expensive ER opioid, like Zohydro or Duragesic, if the OP is not a good metabolizer of hydrocodone or fentanyl.

But, I don't like the way that office handled the situation. They made the patient fearful and suspicious.

Pain management should be a collaborative partnership between patient and clinician. That partnership is based on trust, and clearly, this office jeopardized this relationship through mismanagement. Being a medical professional, even if you're the lowly MA who captures the the swab sample and sends it to the lab, has responsibilities include respecting a patient's concerns. They blew it.

Best wishes, Tuck.
Helpful - 0
547368 tn?1440541785
I understand what you are saying. I also understand the reason behind the DNA swab and the CYP450 family of enzymes.

I have a problem with the fact that the patient isn't given a choice - they pay for the test when many can barely pay for their medications or food- don't forget the cost of the drug screening - and according to my PMP, "They don't have the bugs out yet."

I'm not yet a fan of this DNA testing. I'm never a fan of anything when I don't have a choice and I have to pay for it - and I don't feel it's necessary in most instances. That's my opinion.

Peace,
~Tuck
Helpful - 0
7721494 tn?1431627964
I have to disagree with your both. I'm certain they were testing your pharmacogenetics, and specifically, testing for the genes that produce specific enzymes for opioid metabolism.

These enzymes are called the CYP450 family of enzymes -- there's a few dozen of them. An important one is called CYP2D6, because it is responsible for the main metabolism channel for our most commonly used opioid classes of medication -- these are drugs like hydrocodone, oxycodone, and morphine.

The extent to which you can make CYP2D6 (and other CYP450 enzymes) determines the efficacy of one pain medication of another. With this information, a smart pain doctor can choose the most effective pain medication for you.

And everyone's ability to manufacture these enzymes differs, based on their genetic inheritance.

I call this "smart pain medicine." It avoids the pain and suffering of trying one opioid over another, and waiting to see whether or not it works well for you.

Now, I also believe that all of this should have been explained to you by a smart pain nurse or perhaps even by your doctor.

You see, it took me maybe 5 minutes to write this out. In person I could have told you faster than I did now, but you would have had questions.

That extra five minutes spent with you would make you feel better about your pain management, instead of feeling as you do now -- confused and abused.

N'est pas?
Helpful - 0
547368 tn?1440541785
I agree with you -  so many physicians and the general public treat us feel like drug addicts.

You should demand a copy of the DNA test results. I'll go even further and suggest that you request a complete copy of the last year of your medical records.  Why? - Because you'll learn so much regarding the medical notes your PMP is making - and any thing else that may be going into your permanent medical records. You may be very surprised.

It was another nurse that made that same suggestion to me some years ago regarding obtaining my records from my PCP - a Doc I thought walked on water. Indeed he had been my PCP for 5-6 years. When I obtained my records they were full of half truths, nasty innuendos and some down right lies. I quickly fired that PCP and moved on - but the damage was done. Who believes a patient over a physician? I'll tell you, darn few. It took me years to outlive those records - and prove I was not what or who he depicted on paper.

I ask for a copy of my medical records at least every six months. I encourage everyone to do the same.

I wish you the best Kim and hope you'll be active in our community. We're a supportive bunch - and we learn from each other.

Peace,
~Tuck
Helpful - 0
Avatar universal
I had no choice they said the DNA swab was mandatory. I'm not sure what they tested because this pain doctor didn't even bother to go over the results with me . I will how ever be asking some Questions about it at my next appt. Thank you for your reply. Also you are correct about me having to pay for it. My Medicare covered there portion and i am left with a bill of 78.00 dollars for a test i really didn't even want to take. Seems people like us are more of a Doctor and Insurance scam rather then human beings that would really like to find doctors who will help them . Instead they make us feel like drug addicts and they simply don't care about helping us at all .. Take care
                                                                                     Kim
Helpful - 0
547368 tn?1440541785
Hello and Welcome to our Pain Management Forum. Please excuse my tardy reply.

You are the second person I've seen on our forum in the last few months regarding a DNA test by your PMP. I'm with you. I think a drug test is one thing - we have noting to hide. I also feel a DNA test is an invasion of my privacy. Sadly we are at the mercy of PMP - we either submit or find a new PMP - which is much easier said than done these days.

I have done a lot of research on this new DNA testing. It's a bit confusing. Did your PMP test your CYP450 enzyme system which is critical for the metabolism of some opioids. Although the name cytochrome P450 is somewhat unfortunate—perhaps a better name would have been “drug metabolizing enzyme system”.  It seems to be the new thoughts if prescribing opiates. It is suppose to tell your PMP which opiates you best metabolize - and which you don't.

I asked my PMP about this "DNA" testing and he said he didn't agree with it. His thought are "they don't have all the bugs out of it yet." So at this point with this PMP I don't have to worry about it - at least for awhile.

I'm afraid it's going to be routine practice in the not too distant future. It's frightening to me that anyone has the right to force me to give my DNA - regardless if they view this as a benefit.

Privacy?  Freedom? Chronic Pain Patients are forced to give up both. Don't get me started - I'm so angry with the climate that exists towards Chronic Pain Patients.

Did you have any choice in the DNA swab? You know you'll b charged for it too!! I'm sorry this happened to you. It's a heads up to all of us. Name another situation (unless you've committed a crime - or paternity testing) that you must allow some form of DNA testing?? So are we the same as criminals? It seems to be.

My Best to You,
~Tuck
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