Will “Non-Addictive” Painkillers Help Prevent Drug Abuse?
The past several years have seen an appalling trend, as massive numbers of Americans have become addicted to opiate painkillers. Hydrocodone (Vicodin) and oxycodone (OxyContin, Percocet) are at the forefront in this, as the two most widely prescribed painkillers on the market, and also as two of the most commonly abused pharmaceutical drugs. More than 16,000 people per year now die from painkiller overdose, and many others struggle on in the torture of opiate addiction.
The spread of painkiller abuse has also fueled a resurgence in the rates of heroin addiction, as large numbers of people have shifted to heroin as a cheaper and more readily obtainable substitute for pain pills in many areas of the country. America is under attack by opiate drugs, and the need for effective solutions for pain management and medication to help patients get through experiences such as post-operative recovery is countered by the fact that every time a doctor writes a prescription for such a drug, he or she is placing the patient at risk of addiction and possible overdose. It is a dilemma that faces healthcare providers around the nation, but without an alternative for providing pain relief, they continue on doling out prescriptions for powerful and potentially addictive drugs to their patients.
How Opiate Drugs Work
All that could be about to change, however, as a major paradigm shift appears to be poised to occur in the field of pain management and medicine in general. A paper published in the journal Nature Structural & Molecular Biology earlier this month discusses research conducted by scientists at the University of Southern California into the use of non-addictive painkiller medications. The idea behind attempting to develop non-addictive painkillers depends on an understanding of how opioid drugs work. Their function in the body of a patient or a drug abuser is essentially a counterfeit of a natural process in the body. The brain releases chemicals including endorphins and other similar substances in the normal process of monitoring the mood that a person experiences at any given time. Some of these chemicals affect the body’s perception of pain, and opioids work by acting as a substitute for naturally occurring chemicals in the brain which are involved in this perception. When a person uses morphine, heroin, oxycodone or hydrocodone, the opioids in the drug bind to certain receptors in the brain, bringing about essentially the same effect as endorphins and similar chemicals.
Why Are Painkillers Addictive?
It is in this way that opioid drugs become highly addictive to the user. Every time the person uses the drug, it causes a disruption in the body’s natural chemical processes, and the body will tend to try to adapt to this. The more that the person uses the opiate drug, the more the body will come to depend on the regular dose to cause a release of endorphins. Without the drug, the person’s system will not be functioning normally, and he or she will feel terrible. This is evidenced by the notoriously painful experience of withdrawing from opiate drugs. Thus the person becomes addicted to the medication or drug, and this is the trap into which so many patients fall after being given a prescription for opiate pain pills. Once a person starts taking the medication, it is as though he or she has sailed a ship onto the edge of a whirlpool, and it may become a considerable struggle to avoid getting sucked in. A non-addictive painkiller, to be effective, would have to find a way to get around this problem so that the patient could experience relief from pain without getting hooked.
According to the paper published by the team of USC researchers, there may be a way to deliver such a medication. There are four major varieties of opioid receptors in the brain and spinal cord, and they are the points to which the drugs bind and work their effects on the body. These include the mu, kappa, delta and Nociceptin receptors, and the mu receptors are the primary target of opioid drugs. Research in the past has found that it is possible to mitigate the addictive effects of morphine by giving the patient at the same time a chemical that blocks the delta receptors, and based on this observation the team behind the USC report decided that they should investigate for a way to develop a single medication that would have the pain relief effects of an opioid as it interacts with the mu receptors, while also working with the delta receptors to prevent the addictive effects of the medication. If this could be developed, it would be possible to give patients all the benefits of relief from pain following surgery or in the treatment of chronic pain, while staying safe from the risk of getting hooked on the medication. Using advanced X-ray imaging techniques, the researchers were able to create highly detailed models of a molecule which closely resembles the body’s naturally occurring chemicals, which works to activate mu receptors while at the same time blocking the action of the delta receptors. The work described in the paper appears to be a breakthrough, opening the door for further research and development to eventually bring to market a medication that could help to put an end to the prescription painkiller epidemic that our nation currently faces.
Non-Addictive Opioids Handle Only Half the Problem
Releasing a non-addictive opiate painkiller medication does not mean that there would be an immediate end to the spread of painkiller abuse. Although fewer people would be getting addicted to their medications, there would still be the problem of providing patients with powerful narcotics that have a high potential for abuse. Drug addiction is more than an entirely physiological issue; it’s not just about the physical mechanics of how the drug works on body and brain.
Underlying this is the question of why the person felt a need to numb his or her feelings, thoughts and emotions in the first place. When a person lacks the understanding, tools, and support to successfully handle life, he or she will seek a refuge and escape from the stress and pressure of everyday living. Drugs may provide this way out, and giving a patient opioid painkillers when he or she is also struggling with other life problems opens the door to abuse of the drugs. Even if the pills aren’t addictive, there is still an enormous risk of addiction to other drugs.
As pharmaceutical companies, legislatures, law enforcement, healthcare providers and more work to make it harder to get painkillers for nonmedical use, many people have been shifting to abusing heroin, as a cheaper and more easily found an alternative. A similar problem could play out when giving patients non-addictive opioids. The patient, though not physiologically addicted to his or her medication, may start looking for other ways to get high when his or her supply of pain pills runs out, and this could well end up with heroin abuse, addiction, and overdose, a disturbingly common outcome of the current situation.
The prospect of a non-addictive painkiller is certainly a promising one, but it should not be assumed that this news also announces an end to the spread of painkiller abuse and opiate addiction generally. It is a large step forward, but work must still be done to address the widespread availability of other drugs and to handle the underlying problems that cause addiction and make it persist.
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