Morphine Relief Without Addiction?

Roland Piquepaille writes "Morphine has been used as a painkiller for decades, if not centuries. Unfortunately for patients, morphine is also an addictive substance. Now, Brigham Young University (BYU) chemists are using a vine plant that grows in Australia to develop a new painkilling molecule, but with fewer side effects. The Deseret Morning News reports that the BYU chemists hope to ease pain with hasubanonine, the synthetic compound they created and which has a similar molecular structure as morphine. Still, more tests need to be done before this natural drug can replace morphine."

Comments

Heroin

[snowgirl]

If I recall correctly, Heroin was originally designed the same way, or at least to help people get off of a morphine addiction.

Oops! It turned out to be even more addictive, oh well, let's try again. hehe

Re:Heroin

[Anonymous Coward]

The worst part about both of those drugs is the prohibition against them. Either one can be taken by an experienced user with very little side effects. The damage normally experienced by a user is due to contaminates in the impure street versions of these drugs. Ironically, the (relatively) non-addictive synthetic opioids used to "treat" addiction can causes damage even though they are pure prescriptions. Such is the nature of drugs the government allows people to make money off of and drugs the government makes money off prohibiting.

Re:Heroin

[mysticgoat]

they tried it on a number of the lab personnel and it didn't give any of them withdrawal symptoms.

These early drug studies were limited by a very poor understanding of the nature of addictive behavior. Almost certainly the lab personnel did exhibit the signs and symptoms of physical withdrawal from the opiate, but these weren't recognized as such. Opiate withdrawal symptoms make one feel grumpier and more irritable, and have some signs like a mild flu, and that's it. Of itself, the physical withdrawal from opiates is usually not sufficiently nasty to cause drug-seeking behavior (addiction).

The more severe problem with the opiates is the psychological dependency that can arise in many people. So far as I know, the mechanisms of this aren't well understood as yet. But it does seem that people who are happy at home and facing satisfying challenges in their work are not as susceptible to drug-induced euphoria as, say, someone with limited education and a bleak future.

Google this: addiction dependence habituation. It is a complex field, and not easily amenable to scientific study.

Re:Heroin

[grandgator]

That's not exactly right, but it's close. All opiates (and opiOIDS) work primarily by binding the mu receptor in both the peripheral and central nervous systems. After that point, there is still a lot of unknown in what actually happens with respect to specific signaling cascades, etc. But that's not a result of lack of understanding regarding the pharmacology of opiates/opioids, but rather a lack of understanding what actual biochemical signals/processes/cascades are responsible for producing "pain."

The actual addiction part is not just from what happens to various levels of chemicals when you apply and then remove the drug, but to a larger extent is caused by what actually happens to the number/density of receptors themselves. A difficult problem to combat.

The problem, as many other posts here about heroin and morphine allude to, is that any compound that works via these receptors will cause similar addictive effects. The only way to avoid that it to change the way that the drug targets receptors. But, if you do that, then it's not really fair to have this article. i.e., it would then make about as much sense to say "Pepto Bismol relieves stomach pain without the addictive effects of heroin!" In other words - duh! They're not the same thing.

The reason the mu receptor is a common pain medicine target is because it is SO effective at block pain signals. But, as with so many other things posted here, there is no free lunch. You want big time pain relief? Mu receptors are the way to go. But that means issues with addiction/withdrawal/etc.

Next up: Fire that doesn't burn you!

[user9918277462]

Painkillers (opioid painkillers, specifically) are addictive precisely because of their analgesic effects. Addiction and analgesia are not separate traits, but rather two aspects of the same action. Anything that provides strong central pain relief (as opposed to peripheral analgesia as in NSAIDs) has at least some risk of causing psychological or physical dependence.

Re:Next up: Fire that doesn't burn you!

[Pedrito]

Painkillers (opioid painkillers, specifically) are addictive precisely because of their analgesic effects.

Don't confuse addiction with habit. Addiction is a physical dependency and that aspect doesn't necessarily have any relation to its analgesic effect. Aspirin has analgesic properties, but NO addictive qualities.

What makes opioids addictive is unknown. What makes them analgesic is, to some degree, understood. The two may be linked, but because something is analgesic does not make it addictive. It may be "habit-forming", on the other hand. Marijuana, for example, can be habit-forming, but it is not addictive because one does not develop a physical dependence on the presence of the drug in their system.

Re:Next up: Fire that doesn't burn you!

[Baddas]

Read the grandparent again. Asprin is a drug that acts very similarly to NSAIDs, which he SPECIFICALLY disclaimed

Marijuana is a non sequitur, he's talking about central nervous system analgesics.

Try that one again, this time, with reading comprehension.

For reference:
Asprin: peripheral analgesic
Heroin: central analgesic
Ibuprofen: peripheral analgesic
Oxycodone: central analgesic.

See a pattern here? pethidine, oxycodone, hydrocodone, diamorphine, fentanyl, basically anything that is inhibited by a mu antagonist is going to get you addicted if you take it long enough.

Re:Next up: Fire that doesn't burn you!

[Anonymous Coward]

No, it does not. You have also bought hook, line, and sinker the lie about THC content having increased since the 60's. No, it has not. If you really did experience physical dependence on the drug, then your source of "skunk", as it were, was selling you cannabis laced with something else. Of course, such an occurrence would not be a problem were the government and its agents to stop prohibition and instead move to regulation.

Unless you've used it at that level I don't see how you can know better.

I do not see how you can conclude based on your anecdotal experience that decades of scientific research into marijuana or cannabis somehow have failed to capture this. I return you to the written word from the world's most widely used medical textbook:

Chronic or periodic use of cannabis producing some psychologic dependence but no physical dependence. [emphasis added]

Morphine doesnt stop pain

[Anonymous Coward]

as someone who was recently in hospital and had morphine (and as a person who has done just about every drug there is) i can say it doesnt actually _stop_ the pain it just makes you not care about it, but it was still there even when wasted out of my skull it just makes you not care

now a painkiller that would actually take away pain would iam sure be welcomed

Re:Morphine doesnt stop pain

[saleenS281]

I'm gonna go ahead and guess that it just wasn't effective on you because of your aforementioned other drug "experiments". It turns out things like morphine are basically worthless to ex-crack addicts because they've built up an immunity/tolerance to things that take away pain for most of us.

As someone who was also recently in the hospital, and also recently had morphine, it most definitely takes away the pain.

Re:Morphine doesnt stop pain

[stickystyle]

As someone who was also recently in the hospital, and also recently had morphine, it most definitely takes away the pain.
I would have toagree with the parent also, it just makes you not care, sometimes to the point where you -forget- its there. The pain is still there.
...although i cannot discount your experience, I am not you and everyone reacts slightly differently to medication. You qualify that statement in your post.

Hardly a new concept

[slapyslapslap]

There are several companies out there with similar meds in trials. Pain Therapeutics, Inc. http://www.paintrials.com/ is doing this.

Re:I know what should be used

[pHatidic]

For those who don't know, Freud used cocaine from time to time but never got addicted. However, he gave it to one of his friends to try who later died from his addiction to the substance.

Medical comments:

[olddoc]

I am an Anesthesiologist. I give people morhine and fentanyl on a daily basis.
Morphine is a natural drug, it comes from a plant. Cocaine, digitalis, aspirin and many other drugs are also natural.
If the new drug is related to morphine I take that to mean it will work on the same receptors in the brain.
If it does, it will have a similar side effect profile: constipation, nausea, respiratory depression and probably addictive potential.
To me, this is just a "me too" drug like Tagamet/Zantac/Pepcid that all work the same way on the same receptors.

Interestingly, there is no profit margin in simple morphine. The cost to the hospital for an ampule that would relieve severe pain is on the order of $1.
The DEA paperwork is a bigger cost to a hospital!

The biggest long term problem for people who take morhine (or heroin in the UK or oxycontin or any drug in this class) is constipation.
Cancer patients don't have to worry about addiction.

Re:Medical comments:

[asuffield]

Morphine is a natural drug, it comes from a plant.

Since we haven't yet invented a practical form of transmutation or energy-matter conversion, everything is 'natural', in that it is made from things extracted from plants, animals, or rocks. 'Natural' is an emotive word with no scientific meaning.

Somewhat more to the point, drugs roughly equivalent to morphine (endorphins) are naturally produced by the body on its own, without any external intervention. You can even get addicted to them, if you can be bothered to engage in the heavy exercise necessary (many serious athletes become mildly addicted, and yes, it's real addiction - they show physical withdrawal symptoms if they stop exercising regularly, just like with any other opiate, and can occasionally require medical treatment to manage this if an injury prevents them from training). In no sense can you call an opiate, or any quantity of an opiate, 'unnatural'. It's a fundamental part of how the human body/mind operates (including everything from chocolate to orgasm).

People need to find something less pointless to talk about than whether something is 'natural'.

Do editors read? Roland Piquepaill gets a pass?

[lax-goalie]

In the next to last sentence: "the synthetic compound they created".

In the last sentence: "this natural drug".

Ummm, those two phrases are the complete opposite of each other...

From the F'ing article:

We've synthesized a mixture of the two mirror-image compounds, the idea being we can take the mirror image of the natural one

Mirror image of the "natural one". Sounds like a "synthetic compound" to me...

Across the Big Pond

[Doc Ruby]

How fortunate that tribal Africans spent thousands of years breeding ibogaine for an opiate withdrawal/detox remedy.

Re:Natural drug?

[Anonymous Coward]

You are, in fact, wrong. Morphine is produced by being extracted - not synthesized - from opium. It's made by the poppies, and the people only have to purify it. Synthesis is technically possible, and the morphine synthesis was an important milestone in organic chemistry, but that's because of the scientific insights it involved; synthesis is not the normal production process for morphine. You're probably thinking of heroin, which is synthesized using morphine as starting material.

Re:I know what should be used

[niktemadur]

There's a pretty good movie from the seventies called The Seven Percent Solution, in which Sherlock Holmes teams up with Dr. Sigmund Freud to cure his cocaine addiction, all the while solving a murder case. Of course, cocaine was an over-the-counter drug at the turn of the century. Consider the name Coca-Cola, which originally contained coca leaf extract.

Source with Images

[nmb3000]

Interesting that neither the summary nor the article links to the page at BYU's NewsNet page. It has a few more details, links to other sources, a video, and pictures related to the research.

Actually, Most People Don't Become Addicted

[Anonymous Coward]

There is a small fraction of the population that doesn't get hooked on morphine and its derivatives.

This is misleading. Actually, the vast majority of individuals who use opioids do not develop addiction. Everyone develops physical dependence and it's important to understand the difference. While physical dependence requires that long term opiate users taper thier dose of a long period of time, addiction (psychological dependence) occurs in only a few percent of opiate users.

Opiate addiction is similar to alcoholism. The vast majority of alcohol users will never experience addiction disorder.

For two years I took 60mg of time release morphine (Avinza) for fibromyalgia. Personally, it was much more difficult to quit drinking coffee than it was to taper off morphine (using oxycodone to taper).

Re:Ok, Explain This One To Me

[dsmall]

(1) And here in all the "Heroin was invented to ... " theories and notes above in this thread, has been __lost__ the fact that Heroin, (tm), is a trademark of Bayer. Heroin (tm) was a cough syrup for small children originally marketed in the late 1800's. It was probably quite effective in the same way that, let's say, codeine in a cough syrup is effective. I am not a doctor but I can guess it was an expectorant.

        Wikipedia -almost- has this right but is not correct.

        If pressed I can come up with a .JPG of some Heroin (tm) bottles from Bayer.

        That is really where it came from and that's the deal.

      (Reference Book:
          "Flowers In The Blood: The story of opium" by Dean Latimer. ISBN: 0531098591 )

      (2) The British use heroin in terminal cancer patients on the practical idea of why worry about addiction?

      Having really severely fractured my ankle eight years ago, I too can tell you that some opiates worked and some didn't, and "it's a funny old world" as to which ones work and which ones don't. It is certainly not the ol' "compared to morphine" scale I see written up in medical literature.

      Hence I tend to believe the people who say "Well, I saw weird results" and I tend to shy away from the people who say "Well, things should always be this way because the theory says so!". It's almost ideology and idealists.

      Politics re: George Bush don't even enter into this in my opinion, the drug wars have been raging in Democratic and Republican Administrations as far back as I remember, and I remember Lyndon Baines Johnson. Sorry, folks. I know it's a lot of fun to blame everything on George right now, but this one ... I just can't see it.

      I hope this clears some things up. I think you will find this information to be true as you search it out.

      -- thanks,

      David Small

p.s. This information is true to the best of my knowledge as I write this and represents my personal opinion.

Shipman Effect

[Dr_Barnowl]

Heroin is legal for prescription here in the UK, as it's an astoundingly effective treatment for pain. But doctors are less likely to prescribe it now since the conviction of Harold Shipman, a general practitioner who murdered over 200 victims with overdoses of opiates. Doses which are technically considered harmful are commonly prescribed in cases where the reduction in lifespan is less significant than the reduction in suffering. This practice has reduced somewhat as doctors are understandably keen not to be accused of murder.

While I think this if faulty thinking, at least it's better than a religious reason... that's right up there with Jehova's Witnesses refusing blood transfusions.

Morphine and Heroine addiction are now curable

[MythoBeast]

No, I'm not going to spout religion or philosophy at you, nor am I going to try to sell you something. What I'm going to describe is strongly backed up by scientific evidence, although it's heavily resisted by those who would normally be responsible for telling you about it because it would largely put them out of business.

Opiates in general work because they are similar to endorphins. Endorphins are a chemical in our system that provides a pleasurable sensation when we're doing something that is contrary to energy efficiency, and yet is beneficial to either individual or genetic survival. Exercise, sex, and "thrilling" activities are the primary examples of this, being called "runner's high" "afterglow" for the first two.

Any time we perform a behavior and it results in us having opioids in our system (endorpin, morphine, whatever), the neural links that were recently fired get stronger -- take less effort to fire. This isn't just a matter of "hey, that felt good, I think I'll do it again", it's a matter of reinforcing the neural linkage that recently occured, and this makes us consider those paths to be more favorable when examining our options in the future. This results in opioid addiction, and is also largely responsible for alcoholism. Alcoholics are mostly people whose system produces an abundance of endorphins.

If you don't have a medical background the cure may seem a little anti-intuitive, but medical experts that I describe it to generally nod their head and say "yea, that makes sense". When we perform a behavior and get flushed with opioids, the connections get stronger. When we perform a behavor and DON'T get flushed with opioids, the connections get weaker, returning to their normal state. What this means about a cure is against a lot of people's grain. First, you take something that blocks your opioid uptake. Endorphin antagonists are commonly sold under the names of ReVia, naltrexone, noloxone and nalphemene. They're generally used to ease opiate withdrawl symptoms and to treat alcoholism. Then you feed your addiction.

In case you missed it, I'll say it again. If you perform the behavior (smoking opium, shooting up heroin, get drunk, whatever) and your body doesn't get the opioid flush, then your body unlearns the addiction. For alcoholism, most patients regain the upper hand on their urges after two or three weeks, and can drink socially without fear of overdrinking or going on a binge after about three months. For this to occur, however, the person MUST perform their addictive behavior, and it works best if they perform their habits when and where they normally do.

There is a lot of information about this. If you're interested, the best place to start is probably the Wikipedia entry on the Sinclair Method.