292 | id == 292
292 | category_id == 19
292 | category_order == 16
292 | category_name == Pain
292 | category_color == #C47AC0
292 | slug == OPRM1-pain
292 | title == How the Mu Opioid Receptor Gene Controls Response to Painkilling Drugs (OPRM1)
292 | meta_description == The OPRM1 receptor receives signals from endorphins, enkephalins, and opioid medication. Which variants cause more pain?
292 | summary == <p><strong>The OPRM1 receptor receives signals from endorphins, enkephalins, and opioid medication. Do people with some variants feel more pain&mdash;and need more painkillers&mdash;than others? Find out here.</strong></p>
292 | overall_score_text == Opioid Response Score (based on OPRM1)
292 | image == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/background/OPRM1--Pain-Resp.-to-Painkillers.jpg
292 | author_id == 1
292 | author_name == Jasmine Foster
292 | author_title == BSc, BEd
292 | author_order == 36
292 | author_photo == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/author-photo/Jasmine.jpg
292 | author_intro == <p><strong>Jasmine received her BS from McGill University and her BEd from Vancouver Island University.</strong></p>    <p>Jasmine loves helping people understand their brains and bodies, a passion that grew out of her dual background in biology and education. From the chem lab to the classroom, everyone has the right to learn and make informed decisions about their health.</p>
292 | reviewer == None
292 | medical_reviewer_id == 11
292 | medical_reviewer_name == Puya Yazdi
292 | medical_reviewer_title == MD
292 | publish_date == 2020
292 | publish_date == 8
292 | publish_date == 27
292 | avg_rating == 5.0
292 | tags_id == 651
292 | tags_name == OPRM1 Gene
292 | tags_id == 71
292 | tags_name == Pain
292 | tags_id == 640
292 | tags_name == Painkillers
292 | tags_id == 652
292 | tags_name == Response to Opioids
292 | tags_id == 653
292 | tags_name == Response to Painkillers
292 | permissions_favorite == False
292 | permissions_rate == False
292 | content_article == <p><em><span style="font-weight: 400;">If you have persistent or unexplained pain, it is important to discuss these concerns with your doctor. The information in this post is presented for educational purposes only, and should not be used to replace standard medical care.</span></em></p> <h2><span style="font-weight: 400;">What is OPRM1?</span></h2> <p><span style="font-weight: 400;">The </span><em><span style="font-weight: 400;">OPRM1</span></em><span style="font-weight: 400;"> gene encodes the mu opioid receptor, also abbreviated OPRM1. This receptor receives signals from our </span><a href="http://selfhacked.com/blog/why-the-ice-bucket-challenge-is-so-popular-it-functions-like-heroin/"><span style="font-weight: 400;">natural opioids</span></a><span style="font-weight: 400;"> and from opioid medications [</span><a href="https://ghr.nlm.nih.gov/gene/OPRM1"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Natural opioids produced by the human body include beta-endorphins and enkephalins, which regulate our response to pain signals. Opioid medications such as morphine, oxycodone, and fentanyl take advantage of this system to eliminate the sensation of pain [</span><a href="https://ghr.nlm.nih.gov/gene/OPRM1"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h2><span style="font-weight: 400;">OPRM1 Variants &amp; Opioid Response</span></h2> <p><span style="font-weight: 400;">Two variants in the </span><em><span style="font-weight: 400;">OPRM1 </span></em><span style="font-weight: 400;">gene have been associated with how a person responds to opioid medications like fentanyl: </span><a href="../../../snp/rs1799971/"><span style="font-weight: 400;">rs1799971</span></a><span style="font-weight: 400;"> and </span><a href="../../../snp/rs9384179/"><span style="font-weight: 400;">rs9384179</span></a><span style="font-weight: 400;"> [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390004/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304713/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">A patient&rsquo;s genotype at these SNPs may be used to predict how much fentanyl they will require to control pain after an injury or during a medical procedure requiring anaesthesia. For example, at the well-studied rs1799971 variant, the &lsquo;G&rsquo; allele is associated with reduced sensitivity to opioids. For this reason, the &lsquo;G&rsquo; allele is considered indicative of an increased requirement for fentanyl after injury or surgery and a higher likelihood of developing opioid addiction [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390004/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132783/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">By contrast, the &lsquo;G&rsquo; allele of rs9384179 has been associated with increased sensitivity to opioids. People with one or more copies of the &lsquo;G&rsquo; allele often need less fentanyl to control pain after injury or surgery and may be less susceptible to opioid addiction [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304713/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/19783098/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">The </span><em><span style="font-weight: 400;">OPRM1 </span></em><span style="font-weight: 400;">gene encodes the mu opioid receptor, which diminishes pain signals in response to natural opioids (like endorphins or enkephalins) and opioid medication.</span></span></p> <h2><span style="font-weight: 400;">Your OPRM1 Results for Opioid Response</span></h2> <p>*3016035770183101*</p> <h3><span style="font-weight: 400;">SNP Summary and Table</span></h3> <p><strong>OPRM1 rs1799971</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;A&rsquo; = Associated with normal sensitivity to opioids</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;G&rsquo; = Associated with reduced sensitivity to opioids, increased pain, and increased requirement for morphine after injury or surgery</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">About 37% of all people worldwide have at least one copy of the &lsquo;G&rsquo; allele.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">The &lsquo;G&rsquo; allele is significantly more common in people of East Asian (63%) and South Asian (69%) descent and very rare in people of African descent (1.8%).</span></li> </ul> <p><strong>OPRM1 rs9384179</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;A&rsquo; = Associated with normal sensitivity to opioids</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;G&rsquo; = Associated with increased sensitivity to opioids, reduced pain, and reduced requirement for fentanyl after injury or surgery</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">About 6% of all people worldwide have the &lsquo;GG&rsquo; genotype.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">The &lsquo;GG&rsquo; genotype is more common in people of European ancestry (11%) and almost nonexistent in people of East Asian ancestry (0.2%).</span></li> </ul> <p>*5209791818201437*</p> <h2><span style="font-weight: 400;">Recommendations for Improving Opioid Response</span></h2> <p><strong>A note: </strong><span style="font-weight: 400;">the recommendations discussed here are not intended to either increase or decrease the sensitivity of the opioid receptors, but rather to increase natural opioid release and reduce the necessity for opioid medications.</span></p> <p><span style="font-weight: 400;">This is an important distinction because changing the sensitivity of the opioid receptors may increase one&rsquo;s likelihood of becoming addicted to opioid painkillers. Thus, the best option is to activate the body&rsquo;s existing natural opioids.</span></p> <p>*4042457987924186*</p> <h3><span style="font-weight: 400;">Lifestyle</span></h3> <h4><span style="font-weight: 400;">Applied Cold</span></h4> <p><span style="font-weight: 400;">Cold exposure (e.g., with ice packs) is commonly used to reduce swelling and pain after traumatic injuries. It may also help reduce the pain and need for opioid medication after surgical procedures such as knee replacement and jaw or cruciate ligament reconstruction [</span><a href="https://pubmed.ncbi.nlm.nih.gov/21505324/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781860/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/22972114/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/22626630/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/15915833/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/24713365/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/15809948/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/30798949/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">According to some preliminary research, intermittent swimming in cold water may stimulate pain-relief mechanisms that are mediated by our opioid system [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033575/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Exposure to </span><a href="https://selfhacked.com/blog/12-reasons-embrace-cold/"><span style="font-weight: 400;">cold</span></a><span style="font-weight: 400;"> &ndash; such as by taking cold showers or ice baths &ndash; has also been reported to increase levels of the &ldquo;heat shock inducible factor&rdquo;, a protein that stimulates mu and delta opioid receptors, according to two animal studies in rats [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25108706"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/16171784"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Cold exposure appears to activate the opioid pain-relief system, which may be why ice packs reduce the need for opioid medication after surgery.</span></p> <h4><span style="font-weight: 400;">Acupuncture</span></h4> <p><a href="https://selfhacked.com/blog/acupuncture-benefits-mechanisms-risks/"><span style="font-weight: 400;">Acupuncture</span></a><span style="font-weight: 400;"> is a form of alternative treatment developed by practitioners of Traditional Chinese Medicine. During acupuncture, thin metal needles are inserted at acupuncture points, or acupoints [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458928/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22106073"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Stimulation of acupoints is believed to release </span><a href="https://selfhacked.com/blog/endorphins/"><span style="font-weight: 400;">endorphins</span></a><span style="font-weight: 400;"> and natural </span><a href="https://selfhacked.com/blog/why-the-ice-bucket-challenge-is-so-popular-it-functions-like-heroin/"><span style="font-weight: 400;">opioids</span></a><span style="font-weight: 400;"> in the body, thus reducing the perception of pain. In addition, it also reduces </span><a href="https://selfhacked.com/blog/63-factors-raising-stress-cortisol-level-backed-science/"><span style="font-weight: 400;">stress</span></a><span style="font-weight: 400;"> and tension [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26896946"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">The use of acupuncture to manage pain is highly controversial, but some researchers who study it believe that the body&rsquo;s innate opioid system may play some role in its potential effects. Even if acupuncture&rsquo;s effects are based solely on the psychological &ldquo;placebo effect,&rdquo; this effect could still involve the opioid system [</span><a href="https://link.springer.com/chapter/10.1007%2F978-3-642-10857-0_4"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Additional research is required to investigate whether acupuncture works and how it affects the opioid system.</span></p> <h4><span style="font-weight: 400;">Acupressure</span></h4> <p><span style="font-weight: 400;">Acupressure is a form of Traditional Chinese Medicine similar to acupuncture, except that it involves the use of applied pressure in place of needles. Pressure is applied using the hands, thumbs, fingers, or devices to specific places (called acupoints) on the body. In a trial of 31 cancer patients, acupressure reduced the need for opioids by up to 44% [</span><a href="https://pubmed.ncbi.nlm.nih.gov/26390073/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Acupuncture and acupressure may stimulate the release of natural opioids like endorphins, reducing the perception of pain.</span></p> <h4><span style="font-weight: 400;">Positive Social Contact</span></h4> <p><a href="http://selfhacked.com/blog/the-social-chilled-out-and-empathetic-genes-oxytocin-receptor-snps/"><span style="font-weight: 400;">Oxytocin</span></a><span style="font-weight: 400;"> (not to be confused with oxycodone!) is a neurotransmitter hormone that has long been associated with social and emotional bonding. Some people refer to oxytocin as the &ldquo;love hormone&rdquo; because it is believed to facilitate trust and attachment between individuals [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183515/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Although the mechanisms of oxytocin are quite complex, some researchers believe that at least part of its effects may be due to the stimulation of mu- and kappa-opioid receptors throughout the brain. These receptors may be responsible for oxytocin&rsquo;s purported pain-killing (analgesic) effects [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12169113"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276444/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Some research even suggests that oxytocin could be used as a replacement or a combination painkiller when opioids are inappropriate or insufficient [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276444/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">To naturally boost oxytocin release, seek out positive social contact with people you love and trust. The best way to increase oxytocin release is through skin to skin contact [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290532/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Massage is also a good way to increase oxytocin. In a study of 95 adults, blood oxytocin increased after only 15 minutes of upper back massage. Likewise, a 10-minute foot massage increased blood oxytocin in 40 adult men. In this second study, participants&rsquo; oxytocin levels increased more dramatically when the massage was delivered by hand rather than by machine [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23251939"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Positive social interaction and skin-to-skin contact stimulate the release of oxytocin, which may reduce pain through the opioid system.</span></p> <h3><span style="font-weight: 400;">Diet</span></h3> <h4><span style="font-weight: 400;">Spicy Food</span></h4> <p><a href="http://selfhacked.com/blog/capsaicin/"><span style="font-weight: 400;">Capsaicin</span></a><span style="font-weight: 400;">, the chemical that makes cayenne and chili taste spicy, increases endorphin release and activates opioid receptors in rats. Some people report feeling an endorphin rush-like &ldquo;high&rdquo; after eating very spicy food, but there is little research on this phenomenon [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462993/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273101/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">There are multiple mechanisms by which capsaicin counter-intuitively reduces pain sensitivity. In brain cells, capsaicin activates the </span><a href="https://www.selfdecode.com/gene/trpv1/"><span style="font-weight: 400;">TRPV1</span></a><span style="font-weight: 400;"> receptor. Although this protein triggers inflammatory pain, its repeated stimulation makes brain cells insensitive to pain perception. Capsaicin also seems to reduce the levels of </span><a href="http://selfhacked.com/blog/substance-p-roles/"><span style="font-weight: 400;">substance P</span></a><span style="font-weight: 400;">, which is involved in pain transmission, in the spinal cord [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326624/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://pubmed.ncbi.nlm.nih.gov/2581820/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Consuming capsaicin in spicy food may trigger the release of endorphins, which bind to opioid receptors. Capsaicin also has other pain-killing mechanisms.</span></p> <h3><span style="font-weight: 400;">Supplements</span></h3> <h4><span style="font-weight: 400;">Magnesium</span></h4> <p><span style="font-weight: 400;">In 60 patients who had just had surgery, </span><a href="https://selfhacked.com/blog/21-proven-science-based-reasons-magnesium-amazing-including-drawbacks/"><span style="font-weight: 400;">magnesium</span></a><span style="font-weight: 400;"> amplified the analgesic effect of low-dose morphine in conditions of sustained pain. This early clinical trial confirmed the results of earlier rat studies. In each of these cases, however, magnesium did not itself activate the opioid receptors or release endorphins; rather, it potentiated the effect of another compound that did [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11873038"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19519724"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">It is important to make sure you get enough dietary magnesium to allow opioids and opioid receptors to interact effectively. The best sources of magnesium are nuts, leafy greens, and whole grains [</span><a href="https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Magnesium may be required for opioid receptor signalling. It is important to make sure you get sufficient magnesium through diet or, in some cases, supplements.</span></p>
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292 | content_learn_more_5209791818201437_text == Based on the variants we looked at, your OPRM1 gene is associated with somewhat reduced sensitivity to opioids. However, this doesn't necessarily reflect your overall risk of abnormal opioid response, just one gene related to it. Cold exposure, acupuncture, spicy food, and magnesium may help. Keep scrolling to find out more.
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rsIDs = rs9384179,rs1799971
rsStatus = rs9384179,OPRM1,chr6,154099922,G,A,T,,2,7,HET
rsStatus = rs1799971,OPRM1,chr6,154039662,A,G,,,32,0,Normal
