Opioids are among the most common medications used in the treatment of pain, and they carry many serious risks if used inappropriately. Pharmacogenomic considerations can impact a patient's treatment plan for chronic pain, as CYP polymorphisms may interfere with nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, and opioids. In particular, CYP2D6 polymorphisms may play a considerable part in the safety and efficacy of codeine, hydrocodone, and tramadol, as outlined in the Clinical Pharmacogenetic Implementation Consortium (CPIC) guideline on opioids. Based on current research, the CPIC recently updated its guidance on opioid use and interactions with CYP2D6, OPRM1, and COMT polymorphisms. Greater pharmacist understanding of CYP polymorphisms can lead to safer opioid prescribing and better outcomes for patients receiving pain management.
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