Stanford finds personalized approach to opioids better

Opioids: Stanford researchers find personalized approach a better way to prescribe painkillersBy Denise Dador Dec 2019

This article demonstrates the importance of personalization for quality healthcare and shows that standards are inappropriate for medication choice and dosing.

Why do some people get addicted to opioid painkillers and others don’t?

Stanford School of Medicine researchers have developed an innovative program called the Humanwide Project. Through wearable technology, genetics, and other tools, it aims to personalize care and take the mystery out of how we work.

Debbie Spaizman was nearly sidelined by a health concern. Surgery was needed, but she hesitated due to how she reacted to pain medication.  

“My head would spin,” Spaizman said. “I really was foggy, and I had itching all over my body. But I had no pain relief at all.

To get answers, Spaizman enrolled in the Humanwide Project at Stanford.

The study flips the model on healthcare by personalizing treatment.

This is a critical aspect of healthcare that is threatened by efforts being made by healthcare corporations to standardize all patient care to make it simpler, less variable, cheaper, and thus eventually ineffective.

That includes a deep dive into pharmacogenetics.

Dr. Megan Mahoney, clinical professor of medicine at Stanford said: “Pharmacogenomics specifically tests for genes that look at the rate in which we metabolize drugs. It can determine the dosing of medications and also predict any side effects.”

Meaning our genes can play a big role in how we respond to medicine.

Meaning that standard doses are inappropriate and dangerous, either by giving too much medication or giving too little – either way, the patient suffers.

“We were able to identify the class of opioids that would work for her based on her pharmacogenomic makeup and then she was able to go through with the surgery,” Mahoney said.

“Twenty-five percent of patients had a change in their dose of medication based on the pharmacogenomics test,” Mahoney said.

This is more proof that medication doses MUST be adapted to each individual and that standards are not medically appropriate.

The U.S. Department of Veteran Affairs is making a big push to personalize medicine for its vets. The program will enroll those with a history of cancer but will also inform doctors how patients will metabolize other medicines they need.

Humanwide pilot project brings Precision Health vision to life – Stanford Scope Blog – Amy Jeter Hansen May 2019

“Life-changing” is not a phrase you typically hear in everyday conversation. But that’s how Debbie Spaizman describes her experience as a participant in a Stanford Medicine pilot project called Humanwide.

The idea behind Humanwide is simple: clinicians partner with patients to pull together their individual data, from lifestyle to DNA, and create a comprehensive picture of their health.

This kind of partnership is crucial to the quality of healthcare and is undermined by the current practice of setting “standards” intended to apply to ALL patients.

The care team then helps the patient manage current health conditions and address future risks through a plan aligned with his or her personal goals.

Megan Mahoney, MD, Stanford Medicine’s chief of general primary care, led the design and year-long implementation.

In a paper in the Annals of Family Medicine, she and co-author Steven Asch, MD, outlined the early lessons of the year-long project, which involved 50 patients..

Stanford Medicine leaders invited a videographer and broadcast reporter to document the Humanwide journey through the eyes of Spaizman and four other patients. This clip offers a preview of their compelling stories, which are told through six video episodes, a 30-minute film and six podcast reports:

Spaizman and the other participants underwent

  • genetic assessments that gauged their risk for cancer and other diseases, and
  • a pharmacogenomic evaluation that determined which types of drugs are most effective for their individual biology and cause the fewest side effects.

Here we see that individuals react very differently to the same drugs and require different doses to get the same effects.

The patients also tracked key health metrics, such as blood glucose levels and blood pressure, using portable digital devices that beamed their readings back to their electronic health records for remote monitoring by care teams.

The teams, which included a primary care physician, nutritionist, behavioral health specialist and clinical pharmacist, used this data to inform each patient’s care.

They succeeded in identifying several previously overlooked health conditions and risks for different participants, from hypertension to heightened risk for breast cancer.

For Spaizman, the biggest discovery involved her reaction to certain types of narcotic pain relievers. The pharmacogenomic evaluation helped her doctors prescribe the right drug for her after a planned surgery, so that her pain was alleviated and she didn’t suffer unpleasant side effects.

With Humanwide, we’re able to focus on the whole human: who they are when they’re working, who they are when they’re playing, who they are when they’re at home.

HUMANWIDE | Precision Health | Stanford Medicine
Stanford Medicine  Precision Health  HUMANWIDE

Humanwide is a bold pilot project from Stanford Medicine that uses the latest science and technology to understand each patient, from lifestyle to DNA, and apply that knowledge to transform their health.

The embodiment of Precision Health, the Humanwide model combines cutting-edge tools of biomedicine with a data-driven, team-based approach to focus on what matters most to each patient. The goal: predict and prevent disease before it strikes.

Each person’s DNA contains a wealth of information about his or her health risks. In Stanford Medicine’s Humanwide pilot project, primary care teams used genetic screenings and other assessments to create a comprehensive portrait of each patient’s current and potential health concerns, with an eye toward predicting and preventing disease.

Humanwide FAQs

 

6 thoughts on “Stanford finds personalized approach to opioids better

    1. Zyp Czyk Post author

      It does seem obvious but it’s being denied by all the anti-opioid zealots, who think that a certain dose should be equally effective for everybody under all circumstances.

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  1. Kahty C

    They had to come out with a credible response to the misinformation and lies they spread over the years. Now that the facts are coming out, that people do indeed have chronic pain, it was necessary to promote this common sense approach. As an academic institution, and healthcare provider, Standford got a lot of funding promoting their alternative medicine and misreported science.

    What we have now is industry funded academia, they tailored their research, and combined it with adverting and promotion. “Personalized Medicine” is just another hype, it should be true for any kind of medicine. Just a few years ago they were denying that pain existed, while they cashed in on the opioid hysteria. The foundations and tech billionaires like the idea of alternative medicine. The NIH gave them funding based on the highly promoted and amplified nonsense they were spewing out. Beth Darnell even got invited to Davos, because they like the “Mindset” idea. She is really good at getting media attention, and shamelessly promotes herself on social media. Due to her presence and self promotion, journalists turned to her for insight on pain, and the woo and nonsense, is popular and attention getting.

    They must have realized that people were dying or committing suicide. None of the deaths, drop outs or other adverse events are ever discussed in their “research.” They chose to study basic low back pain,and conflate that with the pain that people have, due to serious health conditions and multiple surgeries. Choosing these subjects ensured a positive outcome for their research, and more money.

    Now they are promoting “Personalized Medicine” as of it is something new. It is pretty frightening, that they can get away with this marketing campaign, and makes on wonder what they did before. People died, lost their incomes, lost their quality of life, and had to endure intractable chronic pain, because of their misreported research and marketing. At the very same time people with addiction problems, due to the epidemic of despair, died too. No one at Stanford or any other academic institution stood up and demanded facts and science. They had access to computer scientists and statisticians, yet they used statistics to game the system, and get media attention. Promoting facts would not have gotten them the funding, or the notoriety they are seeking.

    Stanford just like other academic institutions, saw the so called opioid epidemic as a marketing opportunity. That explains why they did not come out with this “Personalized Medicine” 20 years ago. They saw the death and despair as a way to get funding, so doing research on why, or representing facts about chronic pain were not popular, people like magical thinking. The main thing was to support a broken healthcare system, economic inequality, and downplay the epidemic of despair in America. For Stanford that was where the money was!

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  2. Kathy C

    I just checked out Stanford’s Pain, and found this. https://painnews.stanford.edu/2020/02/its-been-life-changing-how-tms-therapy-gave-mitchell-florn-his-life-back/?sf117519303=1

    Patient testimonials used to be illegal, they are certainly not credible. This cure, is not scientific, anything could have happened. This is nothing more than marketing.

    The FTC did away with the laws back in 2009, helping corporation to cash on the opioid epidemic, using patients fear and pain. https://www.ftc.gov/sites/default/files/attachments/press-releases/ftc-publishes-final-guides-governing-endorsements-testimonials/091005revisedendorsementguides.pdf

    This is not an isolated incident, the FDA hid millions of faulty medical devices to protect the industry.
    https://thehill.com/opinion/healthcare/388634-vulnerable-patients-easy-targets-for-companies-willing-to-sacrifice-ethics

    Medicare for All would have to address deceptive medical marketing, there used to be laws and regulations. Now it is a deadly free for all. Several children in my state died from the flu, because of alternative medicine marketing and misinformation. There are thousands of hospitalizations too, due to complications of the flu. This is just one example of the deaths, and costs that occur, because there is no enforcement on medical misinformation, and deceptive marketing.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      Allowing direct to consumer marketing of medical devices, drugs, or services has created a monster. No other country does this. Our country is “special” in that it places few limits on capitalist reach and greed :-(

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