PRESENTATION MODE — PRESS P TO EXIT

THEME 4 · REWARD, OPIOIDS, ADDICTION

Two percent of people have this one.

OPRMI is the highest-stakes practical finding on the cluster. It is rare, it is homozygous, and the printed multiples are not small.

OPRMI · TH · stimulant pile · CNR1 / PENK · THC / CBD

SHORT VERSION

Pain relief and pleasure chemistry are a poor match for me.

Standard pain meds are printed as a bad fit.
Stimulants are printed as less likely to help.
Cannabis chemistry wants more caution, not less.

FINDINGS

This is the highest-stakes practical finding on the page.

OPRMIGG

2.9%of people carry this genotype

OPRMI GG — opioid non-responder, elevated severe-outcome risk.

Two copies, high impact, 2.9% prevalence. Appears in both the Addiction and the Opioid & Pain Response panels. I am putting the warning on the page before the rest of the cluster.

CNR1TT

6.6%of people carry this genotype

OPRMI GG 2 copies HIGH IMPACT

Opioids are a bad fit, and the printed multiples are not small.

Mechanism

The gene regulates pain and the pleasure response to opioids. Carriers are prone to lower pain reduction with opioids, have increased addiction risk, and increased risk of severe outcomes with opioids, benzodiazepines, and other recreational drug use.

How it shows up

Predicted opioid non-responder for pain relief, with printed severe-outcome multiples of 12.9×, >5×, and ~4×, plus a specific instruction to avoid methamphetamine-containing stimulants.

TH AA 2 copies HIGH IMPACT

A second opioid-side flag sits next to OPRMI.

Mechanism

1.74× opioid dependence risk.

How it shows up

This is not a substitute for the OPRMI row. It is a second printed flag on the same side of the ledger.

SLC6A2 / NTF3 / DRD3 / DRD4 GA · AA · 1 · 1

Stimulant response is printed as weaker, not stronger.

Mechanism

SLC6A2 GA decreased response to stimulants; NTF3 AA methylphenidate-alternative caution; DRD3 and DRD4 C8887A poorer stimulant response. CYP2B6 AG reduced bupropion smoking-cessation success. DBH T15791C less likely to respond to atomoxetine.

How it shows up

COMT already carried decreased stimulant response in males. This pile is the rest of that story.

CNR1 / PENK TT · CC 2 + 2 HIGH IMPACT

The endocannabinoid cluster is not a casual row.

Mechanism

CNR1 TT, two copies, high impact, 6.6% prevalence, with a weight-gain-on-atypical-antidepressants note. PENK CC, two copies, high impact, over 9× cannabis dependence risk.

How it shows up

CNR2 GG two copies sits in the same cluster.

CYP2C9 / FAAH CT · AG

THC and CBD want a lower starting dose.

Mechanism

CYP2C9 CT — slow THC metabolizer; dose reduction advised. FAAH AG — significantly increased THC/CBD-induced anxiety and psychosis risk; start at a lower CBD dose.

How it shows up

I am treating those as caution labels, not as a recommendation to use either compound.

WHAT I DID

I treated the avoid list as standing instructions, not as trivia.

Avoid methamphetamine-containing stimulants. Start low if a clinician ever uses THC or CBD. Sulforaphane is on the daily stack partly because OPRMI is one of the printed drivers.

CROSS-CHECK

Neither scan measures this receptor.

NO OVERLAP

Reward and pain rows are not the same construct as SPECT blood flow or QEEG rhythm. Omitted: any AGREES claim.

KEEP GOING

The adjacent threads sit one click away.

How it works is the primer. The library is the index. The other spokes are the payload.

Want the full avoid list?

The ledger repeats the opioid and stimulant flags in one table.

QEEG · Peak Brain SPECT · Amen