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As with other substance use disorders, both genetic (such as mutations in the opioid receptor gene (10)) and environmental factors (such as exposure to trauma), contribute to the risk of developing opioid use disorder.(11) Ready access to prescription opioid, heroin, and fentanyl have all contributed to the current opioid epidemic

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In the Walsh framework, toxic overload is one biochemical pattern that may coexist with undermethylation, copper imbalance, pyroluria or other contributors

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