Ordering Recommendation

Pretherapeutic identification of individuals who may require higher or lower doses of opioid drugs to achieve adequate pain control or have a better response to naltrexone for the treatment of alcohol and/or opioid dependency.

Mnemonic
OPRM1
Methodology

Polymerase Chain Reaction/Fluorescence Monitoring

Performed

Mon, Thu

Reported

5-10 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Lavender (EDTA), Pink (K2EDTA), or Yellow (ACD Solution A or B).

Specimen Preparation

Transport 3 mL whole blood. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma or serum. Heparinized specimens.

Remarks
Stability

Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 month

Reference Interval

By report.

Interpretive Data

Background Information for Opioid Receptor, Mu OPRM1 Genotype, 1 Variant:
Characteristics:
The mu opioid receptor is involved in mediating the clinical response to opioids (agonists and antagonists). OPRM1 c.118A>G has been associated with lower sensitivity to opioid receptor agonists prescribed for pain control (eg., morphine) and higher sensitivity to opioid receptor antagonists used in the treatment of alcohol and drug dependency (eg., naltrexone). Risk of side effects to opioids is also associated with this genetic variant.
Inheritance:
Autosomal co-dominant.
Cause:
SNP rs1799971; OPRM1 c.118A>G (p.Asn40Asp); also known as G allele alters response to opioids.
G allele frequency:
African Americans 4 percent, Caucasians 14 percent, Hispanics 24 percent.
Clinical Sensitivity:
Drug dependent.
Methodology:
Polymerase Chain Reaction (PCR) and Fluorescence Monitoring
Analytical Sensitivity and Specificity:
Greater than 99 percent.
Limitations:
Only the targeted OPRM1 mutation, c.118A>G, will be detected. Diagnostic errors can occur due to rare sequence variations. Risk of therapeutic failure or adverse reactions with opioids may be affected by genetic and non-genetic factors that are not detected by this test. This result does not replace the need for therapeutic or clinical monitoring. 

Please note the information contained in this report does not contain medication recommendations, and should not be interpreted as recommending any specific medications. Any dosage adjustments or other changes to medications should be evaluated in consultation with a medical provider.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

81479

Components
Component Test Code* Component Chart Name LOINC
2008768 OPRM1 Genotype, Specimen
2008769 OPRM1 Genotype, Interpretation
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Opioid receptor sensitivity (Opioid Receptor, Mu (OPRM1) Genotype, 1 Variant)
Opioid Receptor, mu OPRM1 Genotype, 1 Variant