Genes differentially expressed in both oxymorphone and chronic pain (13 DEGs) included those implicated in TNF response and previously linked to Lyme disease (YBX3,75,76), encoding cytokines (CCL2,77), Raine syndrome and bone mineralization (FAM20C,78,79), autocrine signaling and lipid storage (HILPDA,80), connective tissue biogenesis (LOXL2,81), neurogenesis (RASF10,82), and Alzheimer disease, Parkinson disease, schizophrenia, and PTSD (SERPINA3,83–86). This evidence concerns the gene SERPINA3 and Lyme disease.