It almost appears to be too excellent to be true: discomfort relievers that could be more efficient in relieving pain and less likely to outcome in dependancy and addiction. But that's what scientists from the University of Adelaide and the University of Colorado are on their way to creating following a research on the prospective of a drug known as (+)-naloxone.
Linda Watkins, the lead author of the study, which was published last month in the Journal of Neuroscience that. (+)-naloxone is a mirror image of the drug naloxone, used to treat opiate overdoses. Watkins and her team during their research found that (+)-naloxone can alleviate pain more strongly when paired with opioids than the drugs would otherwise alone, while blocking some of the elements that lead to addiction.
Painkillers represent a class of drugs according to CDC are being abused at alarming rates.Painkillers help millions of people who are battling cancer, recovering from surgery and suffering from chronic ailments. There were 14,800 painkiller-related overdose deaths in 2008 -- more than the number of heroine and cocaine overdose deaths combined. Painkiller sales increased by 300% since 1999, and 12 million people admitted to using painkillers for non-medical reasons in 2010.
While approaching drug physiology in new way,Watkins' team during latest result,could prove to be significant in the effort to curb prescription drug abuse, in part. Watkins noted that in the past, researchers have primarily studied drug abuse and drug rewards in terms of how they relate to neurons. The latest research shows that there may be another key factor, known as glia, that influences how the body responds to drugs. Glia are immune-like cells, behave very differently than neurons, and could prove crucial in understanding how pain and reward messages are transmitted.
"You can think of them as volume controls," Watkins said. "They can turn up pain and they can turn up drug reward, because when they become activated by things like pain, by things like opiates, they start releasing substances that are excitatory, that drive neurons wild."
Watkins and her team found in their research is that when they paired morphine with (+)-naloxone, the drugs effectively blocked a receptor attached to the glia cells, making the pain-relieving aspects of the drug stronger while apparently negating drug rewards.
In one study performed, rats were put into two rooms, one of which had saline and one of which had morphine. Conditioned behavioral response dictates that the rats would want to return to the room that had the morphine in it. But once the rats were given (+)-naloxone with the morphine, they no longer showed a preference for that room and were just as attracted to the saline one.
"Now you have separation of effects," Watkins said. "You can enhance the ability of opiates to be good in the clinical control of pain while at the same time decreasing the abuse potential."
Watkins noted that there are two ways the abuse potential is decreased: it's directly reduced by eliminating the reward, and secondly it's indirectly reduced if opiates work better with the addition of (+)-naloxone, allowing users to require less opiates in the first place.
The research is in its initial phases, and there remain many more questions that need to be answered. As Maia Szalavitz outlined in Time, "it is not clear whether preventing the high would hinder certain aspects of pain relief in humans. Subjective experiences of opioid use suggest that the 'high' — the relief of anxiety and sense of distance from the pain — is not totally separate from the actual physical pain relief, and multiple previous efforts to dissociate the two have failed."
Szalavitz went on to argue that heroin was initially meant to be a less addictive form of morphine and that OxyContin was intended to be a less addictive painkiller. Those attempts at non-addictive opioids didn't pan out as hoped for.
Scientific American raised the issue over whether an addiction-proof painkiller might be of any help to someone already addicted to painkillers, noting that, "there’s a big difference between blocking the effects in a rat that’s only had a few days experience, and blocking them in a years-long addict. Reward related systems change very drastically after long-term exposure to drugs like morphine or heroin, and remember, this has not been tested in humans."
Watkins believes an "addiction-proof painkiller" is something that could indeed become a reality.
"It's early on, but the data are suggestive of that," she said. "It certainly is worthy of a lot more study to see whether this may actually turn out to be the case."
Watkins also noted research from other scientists that shows the potential for a longer-acting version of (+)- naloxone to control drug cravings.
"You can take a person through detox to get them off of drugs, but the real question is whether they will stay off the drugs," Watkins said.
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