To the outsider Dr. Howard Wetsman, chief medical officer for Townsend, an addiction treatment center, is a White man. But since he was adopted he was always curious about his background, so he took a test with 23andme.com, a company that does genetic testing. He knew he was half Irish and Jewish, but also discovered that he had genetic markers in his liver that indicated he had African heritage.
According to an article on the American Addictions Center’s website, Wetsman said, “I have the 3A4 mutation. If you have this mutation and someone gives you buprenorphine, you metabolize it faster. In the case of buprenorphine, metabolizing degrades it, reducing its effectiveness.”
This discovery made Wetsman, a psychiatrist who specializes in addiction, reconsider how the medical community deals with medication and addiction when it comes to African Americans. Because of his African heritage, Wetsman realized certain medications wouldn’t work well with him.
According to Wetsman, this is an issue that is not talked about in the medical field.
“African Americans might react differently to drugs because of genetic issues,” said Wetsman.
Wetsman pointed out that Plavix, a blood-
thinning drug commonly prescribed for heart problems, only works if your body produces a certain enzyme. And, buprenorphine, a drug used to treat opioid addiction doesn’t work well among Black Americans. Wetsman said that during the early years of its use, medical experts thought that urban dwellers simply didn’t want to get off drugs, not knowing it requires higher dosages in some African Americans.
“Nobody thought about a genetic difference,” he said.
Wetsman added that it was important African Americans talk to their doctors about these issues and how drugs affect different ethnic groups.
“I think the most important issue is that this is real,” he said. “African Americans might react differently to drugs because of genetic issues.”
However, Wetsman added this is a touchy subject in the medical/scientific community because it brings up the specter of eugenics which have long been used as an excuse to explain differences in intelligence, but scientists have proven that intelligence is not a genetic trait.
Wetsman said learning about his background has given him a greater understanding and appreciation of genetic testing. He encourages members of the Black community to discuss this issue during doctor’s visits.
“The most important issue is talk to your doctor about ethnic differences in medicine,” Wetsman said.
