Culturally informed pharmacogenomics in opioid prescribing

This minireview examines how integrating cultural factors with pharmacogenomics can enhance opioid prescribing practices. Cultural context, including traditional beliefs, family dynamics, and collective identity, significantly impacts patient engagement and treatment outcomes, particularly among minoritized populations. Concurrently, genetic differences in opioid metabolism and response, notably involving genes such as CYP2D6, CYP2B6, OPRM1, COMT, and ABCB1, underscore the need for personalized pharmacogenomic approaches. Actionable genetic variants are not evenly distributed across populations, further highlighting the importance of culturally informed care. Combining culturally sensitive frameworks with pharmacogenomic testing can improve equity and effectiveness in pain management and opioid use disorder treatment. Key recommendations include integrating cultural competence into clinical pathways, expanding access to pharmacogenomic screening, improving provider education, and promoting inclusive research. Ongoing challenges include limited representation in genomic studies and practical barriers to implementation. Future efforts should prioritize developing scalable, inclusive models and evaluating long-term outcomes to optimize culturally informed pharmacogenomics in opioid prescribing.