Tuesday, April 24, 2018

CORALVILLE — When it comes to admitting how much they smoke or drink, people aren’t always the most truthful.

“People lie like rugs,” said Dr. Robert Philibert, founder and CEO of Behavioral Diagnostics LLC.

His company, started in 2009, can use DNA extracted from a drop of blood to tell not just whether a person smokes or drinks, but how many cigarettes a day he smokes or how many servings of alcohol she drinks.

The technology has applications for health care professionals trying to understand patients’ needs, said Philibert, a UI professor of psychiatry and biomedical engineering.

“People want to be seen favorably by their physicians,” he said. “But if we don’t know (about addiction), we can’t treat it.”

Behavioral Diagnostics is working toward approval from the U.S. Food and Drug Administration for medical applications. In the meantime, the company this spring will start marketing and selling testing services to lawyers, employers and insurers — all of whom may have reasons for wanting to know whether people are regular smokers or drinkers.

A lawyer might use this test to show his client isn’t a heavy drinker, as claimed by a spouse as part of a child custody case, Philibert said. Someone convicted of drunken driving could take the test once immediately after arrest and again a year later to show improvement, he said.

Insurers could raise premium costs or decide not to offer life insurance based on a person’s tobacco use.

The tests from Behavioral Diagnostics are different from what’s already available, he said.

Breathalyzer tests measure blood alcohol content at the time of the test and blood tests can show the presence of nicotine, alcohol or other drugs circulating through the blood stream. Behavioral Diagnostics’ tests don’t measure the chemicals, but the body’s responses to smoking or drinking alcohol.

“The more you drink, the more you change,” Philibert said. “If a person is getting to .08 (blood-alcohol level) a couple of times a week, we’re going to see that.”

It’s also harder for people to cheat on the Behavioral Diagnostics test because even if someone stops smoking for a week before a test, it still will detect previous changes in the body because of smoking.

“In a light smoker, we’ll see the signature disappear in about a year,” Philibert said. “With heavy smokers, it can take many years.”

Using genetic testing for insurance purposes raises ethical concerns for people who worry patients could be screened out because of their DNA. Behavior Diagnostics’ tests don’t measure genetic markers, but rather epigenic changes triggered by behavior.

Still, ethical questions may arise.

Heavy drinkers or smokers likely are going to have more health problems associated with their habit. But if they can’t get affordable health insurance they may skip health care and face worse outcomes or use more expensive emergency care.

“I’m interested in making sure these (tests) are used beneficently,” Philibert said. Because he owns the patents for the tests, he said he and his partners can control how they are used.

He has hired a medical ethicist to help with those decisions, he said.

Much of Philibert’s research has been done with federal grants. In 2016, the company received $1.4 million from the National Institutes of Health to complete the commercialization of the test to detect alcohol consumption.

The company’s plans include tests that can use saliva instead of blood and smoking cessation treatment with artificial intelligence.

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