Role of ALDH5A1 in methadone treatment

Since its introduction in the 1960s by Dole and Nywswander [1], methadone maintenance treatment (MMT) is the most widely used therapy to treat opioid dependence and is considered its first-line treatment. Its efficacy has been proven in terms of decrease of heroin use and retaining patients in treatment; also, it reduces the risk behaviors associated with HIV infection, decreases criminal behavior related with drug use, reduces the risk of fatal overdose and improves health-related quality of life [2]. However, between 30 and 80% of treated patients relapse in heroin use or drop out from MMT [3]. Besides moral concepts and prejudices that hinder legislation and interfere with the implementation of MMT programs based in the scientific evidence to improve their effectiveness [4], in the last decade there has been an increasing interest in the study of the influence of pharmacogenetics in order to develop individualized therapies in response to interindividual variability in MMT response.