The other side of the opioid crisis:  People in pain

Opiods in prescription painkillers have ruined lives, families, and even decimated entire communities.

According to the American Society of Addiction Medicine, 100 million people are in chronic pain and 2 million of them had an addiction to opioids in 2015.  More than 20,000 deaths associated with prescription pill overdoses occurred in that same year.

With more people suffering from the effects of this epidemic, drug authorities have cracked down on prescribers and users.

The problem with taking away opioids, however, is that it leaves real people in real pain.

Injuries, accidents, and chronic health conditions can all leave people with debilitating pain, and sometimes opioids are the only thing that can provide relief. But, with relief, comes the real danger. Tolerance to the medications builds up, breathing becomes increasingly depressed at higher doses, and movement is impaired. It doesn’t take long before a real person in real pain is at risk for overdose.

Some solutions are on the horizon, however.

James Zadina of the Tulane School of Medicine, has been working for two decades to develop a painkiller with the power of opiates without the addiction.  Traditional painkillers work by binding to mu receptors in between nerve cells.  The painkillers flip a switch, making nerves unable to send pain signals to the brain.  The problem with this approach is that in addition to blocking pain, the drugs also activate other cells, called glia. These cells can actually cause the body to feel more pain after the drug wears off.  This leads to an increase in drug tolerance and a higher likelihood of overdose over time.

Zadina’s research is centered around finding a synthetic version of a chemical already present in the human body that helps to mitigate pain – endomorphin.  This compound, related to the endorphins that make people feel better during exercise, doesn’t activate the glia cells like opioids do.  It is likely that they would provide many of the benefits that traditional painkillers have without many of the side effects.

In a 2016 report in the journal Neuropharmacology, Zadina’s team reported success in tests on rats. Human trials will be next but the process could take years.