The Opioid Crisis — A Case of Mass Homicide?

STORY AT-A-GLANCE

  • The inappropriate treatment approach to back pain and post-surgical pain from tonsillectomies and wisdom teeth removal are driving forces behind the opioid epidemic
  • Insurance claims data reveal 60% of children between the ages of 1 and 18 with private insurance fill one or more opioid prescriptions after surgical tonsil removal. Dentists wrote 18.1 million prescriptions for opioids in 2017
  • Research shows opioids (including morphine, Vicodin, oxycodone and fentanyl) fail to control moderate to severe pain any better than over-the-counter drugs such as acetaminophen, ibuprofen and naproxen
  • The American College of Physicians’ guideline for low back pain call for the use of heat, massage, acupuncture or chiropractic adjustments as first-line treatments. When drugs are desired, nonsteroidal anti-inflammatory drugs or muscle relaxants should be used
  • While clinical practice guidelines call for nonpharmacological intervention for back pain, most insurance plans avoid paying for such treatments, favoring opioid treatment instead

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Is the Medicinal Herb Kratom Safe, Effective and an Alternative for Treating Pain, Anxiety and Depression?

Mitragyna speciosa, also known as “kratom,” is a plant native to the rainforests of Southeast Asia that has long been used in traditional herbal medicine to treat pain, boost energy, alleviate anxiety and depression symptoms, and promote feelings of wellness and happiness. But because Continue reading

Opioids Linked to Higher Risk of Pneumonia in Older Adults

Risks highest for long-acting opioids and new use, says Group Health study

Opioids – a class of medicines commonly given for pain — were associated with a higher risk of pneumonia in a study of 3,061 adults, aged 65 to 94, e-published in advance of publication in the Journal of the American Geriatrics Society. The study from researchers at Group Health Research Institute and the University of Washington (UW) also found that benzodiazepines, which are drugs generally given for insomnia and anxiety, did not affect pneumonia risk.

“Pneumonia is a common infection that can have serious consequences in older adults,” said study leader Sascha Dublin, MD, Ph.D, a Group Health Research Institute assistant investigator and Group Health primary care physician.

“Opioids and benzodiazepines work in different ways, but both can decrease the breathing rate. Both are also sedatives, which can increase the risk of aspiration.” Aspiration is inhaling material (including saliva or food particles) from the mouth into the lungs, which can lead to pneumonia.

A 2009 study estimated that two million Americans Continue reading

Soothing Chronic Pain with Meditation is Best

Chronic pain is estimated to affect over 76 million people, more than diabetes and heart disease combined, and back pain is our country’s leading cause of disability for people under 45. And though the pharmaceutical industry seems very adept at introducing one new painkiller after another, the pills don’t always help. A new study in the Journal of Neuroscience, however, suggests something else might: meditation. It seems that improving your meditation technique could very well be more effective than painkillers at cutting down on pain, and that could save you hundreds in prescription drug costs.

The details: This was a small study that looked at just 15 adults who sat through four 20-minute training sessions on mindfulness meditation. However, before and after the training, the participants’ brains were scanned using magnetic resonance imaging (MRI) Continue reading

Rare Type of Tree Bark to Relieve Serious Pain According to Study

A new study published in the journal Nature Chemistry provides new insight into the power of a rare type of tree bark to relieve serious pain. Scientists from the Scripps Research Institute (SRI) in Florida discovered that the bark of the Tabernaemontana divaricata plant, also known as crepe jasmine, contains a compound known as conolidine that appears to be just as effective at treating pain as morphine, but without all the harmful side effects.

Glenn Micalizio, an associate professor at the SRI Department of Chemistry, and his colleagues first had to figure out a way to synthesize conolidine in order to study it. Once they did, they discovered for the first time that conolidine is an effective alternative to traditional opioid analgesics. And because it does not cause nausea, constipation, breathing problems, and even death like morphine can, conolidine has great potential to become a natural replacement for this and other pain medications.

Not an opioid itself, conolidine remains a bit of a mystery. Researchers are not quite sure how the substance works to relieve both acute and inflammatory pain in a similar way as opioids do without acting upon the same cellular receptors.  Continue reading

Is Snail Saliva as Effective as Morphine?

To treat severe pain, a sea snail may hold an answer. Scientists have developed a new medication first isolated from sea snail saliva that may be as effective as morphine.

Sea snails may not move fast, but what they lack in speed, they more than make up for in chemicals. These animals have the ability to inject a mixture of toxins called conotoxins into their targeted prey using their needle-like teeth.

These conotoxins consist of peptides that can relieve severe neuropathic pain as effectively as morphine, but it does not lead to addiction. Attempts to transform these conotoxins into a drug that could be used as a pain reliever has been challenging. Thus far a synthetic version has been developed, but it must be injected directly into the spinal cord using an implanted pump.

Now, a team of scientists in Australia have developed a conotoxin that can be taken orally. In tests with rats, the new drug proved to be as effective a pain killer as gabapentin, which is the most popular drug to treat neuropathic pain. Compared with the dose of gabapentin needed to treat pain, however, the conotoxin-based peptide (named Prialt) is less than 1 percent.

The research team, led by David J. Craik of the Institute for Molecular Bioscience at the University of Queensland, noted that peptides have generally been regarded to be poor pain killers because they are not stable and mostly not available in oral form. One exception has been the immunosuppressant cyclosporine.

Could a drug based on sea snail saliva be next? Jon-Paul Bignham, a professor of molecular biosciences and bioengineering at the University of Hawaii, Manoa, pointed out that an oral drug that has the pain killer abilities of Prialt “would absolutely revolutionize how we manage chronic and terminal pain.” Move over, morphine.

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Chemical & Engineering News 2010