The world is supposedly on the cusp of developing non-opiate based–and therefore non-addictive–painkiller medications.
If this is true then it would definitely make a significant impact in the war against opiate overdoses and addictions.
But it sounds like the drug discussed here is quite localized rather than being general. Reuters says that “The drug is administered during surgery, before the wound is sutured. An earlier study showed PRF-110 was able to relieve pain for up to 72 hours – 10 times longer than the current standard of care.”
So obviously this is only going to work for certain types of pain, and certain types of injuries. Other conditions which cause pain are still going to require a more generalized painkiller that can affect the whole body.
In order to understand how this works, we need to take a closer look at how the human body handles an opiate drug, and what actually happens in the brain.
Every human brain has a number of opiate receptors in it. Those receptors can be “filled up” with either dopamine that is produced from your own body, or from an opiate based drug that is introduced from the outside. When the opiate receptors fill up with dopamine or opiate molecules, it causes the human body to feel relief. The effect is actually similar to putting a rag in a ringing alarm clock. The opiate is the rag and the clanging alarm bells are the pain signal. The opiate molecules filling up the opiate receptors in the brain is much like sticking the rag in between the clanging bells–it dulls the pain.
It is important to realize that opiate based drugs do not actually do anything to reduce the pain or the inflammation in the body. The pain signals are still being sent from the body to the brain to alert the person that something is wrong. The “alarm bells in the brain” are still clanging together, even after you take opiate drugs. But the opiate based medication is akin to putting that rag in between the clanging bells so that you no longer notice the pain as much. If a human takes enough of an opiate molecule it will eventually overwhelm the opiate receptors in the brain and put the person into a coma. At extreme levels the person will stop breathing entirely as well.
So in order for us to develop new types of pain medications it is important to understand how the pain signals work in the body. There is typically a source of the pain and it originates from a certain site in the body. Then that site sends a pain signal to the brain. Taking an opiate based medication simply makes our brain care less about the pain signal, but it doesn’t actually reduce the pain signals that are being sent, and it doesn’t really interrupt them or stop them either. Instead, the opiate molecules medicate the brain and “dope it” so that the human mind cares less about what is happening around it, including the pain signals. That is how opiates affect the brain.
Some medications are showing some promise in terms of a healthier compromise between the two extremes, those being “completely doping a person into a coma” and “giving them a painkiller that is so mild that they are suffering from extreme pain still.” Somewhere in between those two extremes is the level of medication that we desire for patients who are pain, and being able to reduce the potential for addiction is now a very real goal that scientists are striving for.
Ibuprofen is a type of painkiller that actually reduces inflammation in the body, and therefore it reduces the amount of pain signals that are being sent to the brain. It is able to do this right at the source of the pain in the body, right where the inflammation has occurred. But again, not every type of pain in the body is going to be able to respond to this type of painkiller. Therefore we still have demand for an alternative to opiate based painkillers with less potential for addiction.
One of the substances that is already on the market, but that is not currently marketed for pain management, is buprenorphine. This is sold under the brand of Suboxone or Subutex, and it is marketed as a maintenance style drug for recovering opiate addicts. If a doctor prescribes it for pain management then they are doing so “off label,” and this incurs some risk to the doctor, which is obviously not desirable.
What makes buprenorphine unique is that it is only a partial opiate rather than a “full opiate.” This means that after the buprenorphine molecules fill up all of the opiate receptors in the brain, they stop flooding the system and they do not produce a euphoric high, they do not produce a coma, and therefore they have far less potential for abuse. But the medication can definitely be used to treat pain in a way that NSAIDS, aspirin, and Tylenol cannot do. This is because it acts like an opiate painkiller while not being overpowering. If you give a person a dose of buprenorphine they will get a certain amount of relief up to the point that you fill their receptors, but then if they take more it will not get them any more relief, nor will it get them high.
So it is this type of medication that is being researched, something that can provide just the right amount of opiate based relief while not being able to be abused in the traditional sense.
Hopefully if the drug research companies can figure out alternatives to addictive opiate medications, the FDA and other regulatory agencies can rush them through to the market quickly so that they can actually save more lives sooner rather than later. This remains to be seen, and hopefully the new batch of non addictive medications that they develop will not have to go through the usual and slow testing process in order to be approved. We need all the help that we can get in terms of the current opiate epidemic, and safer medications being developed could be at the top of the list.
If you or someone that you love is struggling with opiate addiction, consider calling an inpatient treatment center today. Until we have safer alternative painkillers, going to inpatient treatment is still our best possible response to addiction.