To the Editor: We read with interest the article regarding Australia's approach to managing the challenges of pharmaceutical opioid utilisation.1 The various regulatory, service delivery and educational activities described would appear to provide a comprehensive response to this problem. However, we were surprised to note the absence of any reference to the potential of pharmacogenomics in identifying patients at increased risk of opioid toxicity.
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- 1. Campbell G, Lintzeris N, Gisev N, et al. Regulatory and other responses to the pharmaceutical opioid problem. Med J Aust 2019; 210: 6–8. https://www.mja.com.au/journal/2019/210/1/regulatory-and-other-responses-pharmaceutical-opioid-problem
- 2. Royal College of Pathologists of Australia. Position statement: utilisation of pharmacogenetics in healthcare. Sydney: RCPA, 2018. http://www.rcpa.edu.au/Library/College-Policies/Position-Statements/Utilisation-of-pharmacogenetics-in-healthcare (viewed July 2019).
- 3. Crews KR, Gaedigk A, Dunnenberger HM, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update. Clin Pharmacol Ther 2014; 95: 376–382.
- 4. Gammal RS, Caudle KE, Quinn CT, et al. The case for pharmacogenetics‐guided prescribing of codeine in children. Clin Pharmacol Ther 2019; 105: 1300–1302.
- 5. van der Wouden CH, Cambon‐Thomsen A, Cecchin E, et al. Implementing pharmacogenomics in Europe: design and implementation strategy of the Ubiquitous Pharmacogenomics Consortium. Clin Pharmacol Ther 2017; 101: 341–358.
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