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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."
I don't read your sig. Why are you reading mine?
If it does, it will have a similar side effect profile: constipation, nausea, respiratory depression and probably addictive potential.
Not exactly. Peripheral opioid antagonists, like methylnaltrexone, can neutralise effects like constipation without affecting CNS sctivity. In theory, even respiratory depression may be averted since it's a different MOR subtype involved in that autonomic role, compared to the analgesic circuit (although I'm not aware of any products so far).
And you Slashdot libertarians can wait until your family member has chronic pain - so you can wonder why republicans don't want them addicted.
:)
We don't need to wait. We already understand the republicans' failure to protect personal choice. That's one of the reasons that we are libertarians.
Lighten up; we libertarians are on your side in this fight, even if you are a democrat
If you read TFA instead of the completely misleading summary, you'll note that...
(1) The BYU chemists don't know if the compound has painkilling properties at all. It's the mirror image of another molecule which is known not to be a painkiller. The mirror image is similar to morphine, so they hope it might have the painkilling properties of morphine. But it's painkilling properties are at this point entirely theoretical.
(2) They have no clue whatsoever whether, if it has painkilling properties, it is less addictive than morphine. It just as easily be more addictive. All they know is, while it looks like morphine, it isn't exactly morphine, so it will probably have slightly different properties.
(3) And of course, they have no idea whether the new molecule would have other, less desirable differences from morphine -- like being a deadly poison to the kidneys. Whether the stuff could even be safely taken by humans is still unknown.
In short, the summary on this article wildly exaggerates its content.
If I recall correctly, Heroin was originally designed the same way, or at least to help people get off of a morphine addiction.
you might be thinking of methadone to treat a heroin addiction.
No, he WAS thinking of Herion.
The drug chemists were trying minor modifications on the morphine molecule, trying to find something with the pain relief but without the addition. This new one had all the pain killing power, so they tried it on a number of the lab personnel and it didn't give any of them withdrawal symptoms.
So they marketed it as the "Heroine" that would rescue the world from addiction by killing pain without hooking. Only to discover that it hooked at least as well as it cured pain.
Turns out:
a) The body jut converts it back to morphine.
b) There is a small fraction of the population that doesn't get hooked on morphine and its derivatives. And it happened that all the people in the lab they tried it on were members of that subset - a statistically unlikely occurrence.
(There was a theory that such people also gravitate toward research science fields, such as chemistry and medicine, for unknown reasons, though I haven't heard whether this was ever checked out.)
= = = =
One of the most tragic parts of the whole additction / drug war / underprescription of painkillers by doctors for fear of prosecution is that morphine and derivatives, given in appropriate doses for relief from actual severe or chronic pain, apparently DON'T addict. It's a dose spike far above the pain-relief level that sets the hook. (Not that it's easy to tell in chronic pain cases, since the return of the underlying pain is a fine substitute for withdrawal symptoms. But for acute pain tapering the dose - even (especially) by self-administration, also tends to avoid the hook.
But DEA scrutinizes doctor dosing habits and sporadicly prosecutes doctors who prescribe "too much" narcotics. And they don't adequately take into account whether the doctor is a specialist in pain treatment or treatment of illnesses with a lot of associated pain, and thus have an atypical patient mix biased toward need for pain medication and high doses.
So doctors underprescribe. And that leaves many chronic pain sufferers with no alternatives but ongoing excruciating pain, suicide, or recourse to illegal drugs (with their uncertain strengths, and high cost requiring IV administration with its sudden onset, leading to dose spikes and addiction).
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
The vast majority of people who must use morphine for medical reasons, even those requiring long term use, don't become morphine "addicts" as we normally use the term. Most users wean themselves off the drug relatively easily when the pain they used the morphine to suppress goes away. Many drugs, with and without neurological effects, are physically addictive in that suddenly stopping the intake of the drug causes illness yet no one speaks of "beta blocker addicts."
Addiction to psychoactive drugs arises from the psychological instead of the physiological effects of the drugs. New drugs that offer the the same psychological effects as traditional drugs will present most of the same addiction issues.
Coca-Cola still contains coca leaf extract. It's just that they chemically remove all traces of cocaine from it.
One reason why Coca-Cola can protect the taste of their product from being replicated is that they are one of the few (if not only) US companies that can legally use coca leaves.
Happy people make bad consumers.
It would be more acurate to say that heroin was self-prescribed to anybody with a Sears Catalog, even came with the syringe.
D6 63 0D 70 89 81 BB 8E 7B 7C 5F 5D 54 EA AB 73
The submission, as well as TFA, refer to this compound's potential for pain relief without the "addictive" properties of morphine. The article does not, however, discuss the differences between the psychological condition of "addiction" versus the physical condition of "dependance". Any drug with the ability to relieve pain, cause sedation, or change neurotranmitter levels are potentially addictive. Hopefully this new drug does not create the physical syndrome of dependance created by older, more traditional, opiates.
That said, such a drug is already on the market, Tramadol. Tramadol delivers on it's promise of pain relief without dependance, however, it does not have the potency. Tramadol only exhibits about 10% of the analgesic effect of morphine.
If this new drug offers relief from moderate to severe pain without the physical issues caused by opiate agonists, it would be a welcome breakthrough. Many chronic pain sufferers (myself included) spend their lives dependant on medications that cause awful side effects if abruptly discontinued. A pain reliever that does not create this problem would certainly be useful in treating legitimate pain.
But, I suspect the title of this posting and TFA itself, are somewhat misleading - there is nothing that can alleviate the psychological problem of addiction in those seeking to abuse medications.
"Adventure? Excitement? A Jedi craves not these things."
..once you understand that the highest levels of government and finance are in the "illegal" drugs business. They make way too much money and can garner outrageous amounts of socio/political control by running those businesses and by keeping a huge variety of drugs "illegal". They profit immensely more by forcing people into the underground.Tthey make money legitimately by the bucketful with "legal" drugs, then they just plain clean up on the illegal side. It is the mother of all cash cows and it has lead directly to the police state they so much love and enjoy. Double plus good for crooked globalist "government", or should I say "rule by terror".
Yes, but COX-3 is felt to be restricted to the central nervous (brain and spinal cord), so the previous poster is correct, as far as we know, that paracetamol is a good example of a pain medication that is not addictive but does act on the CNS (this would also be a good explanation as to why paracetamol is a reasonable anagesic and antipyretic [working on the hypothalamus], but lacks the additional anti-inflammatory and anti-platelet properties possessed by ASA, a non-specific COX inhibitor).
As a neurologist, many of the drugs that I use to treat neuropathic pain in my MS patients act centrally but are not addictive (eg. amitriptyline, tegretol, gabapentin, etc.), though patients can be physically dependent (provided they can tolerate them!).
Someone I cared about died of cancer, and I've never been able to figure out what the big deal would be about providing heroin (or whatever it took) to people who are not expected to live in any case and whose last days are, quite frankly, very bad. Why do we have to worry about addicting them to drugs when their days are numbered? My understanding is that in the UK, and other places, a "cocktail" of drugs is administered that can include heroin and that provides some comfort to people in those final days.
In my own experience, the approach to administering opiates and various other "strong" drugs in hosptals here in the U.S. has changed over the past ten or twelve years. I had a rather painful illness and surgery about a dozen years ago and found myself pleading with assorted nurses for pain relief. The post-operative interval was spent in a haze of incoherent pain. Two years ago I had another illness and hospitalization, and they hooked me up to a pump which allowed me to administer the drugs to myself as I felt I needed them. My recovery was much more rapid, I was up and moving much sooner, and I regained strength and normality much faster. I also didn't require anything for pain after I was released from the hospital.
Our "war on drugs" seems to me to be full of misplaced zealotry. I guess ill and dying people are stationary targets, easier to control than the flood of illegal stuff that sometimes threatens to overwhelm us.
"Here's what's happening. You're starting to drive like your Dad..." - Red Green
>even (especially) by self-administration
While recovering from the surgery that bought her a couple of extra years of life, my mother had a patient-controlled Demerol pump. The fascinating thing about those is not that the patients get (duh) better pain control but that their total narcotic consumption is actually lower than when the medical people decide how and when to dose.
Well, how else do you explain the irrational resistance to alleviating pain? What, an old man that's going to be dead in a month will get addicted to morphine? The reason for this isn't medical, moral, financial, or at all rational. So, what's left? What irrational belief would encourage otherwise normal people to allow someone to suffer when it would be so easy to prevent it? The same forces which pushed for the prohibition of drugs also pushed for the prohibition of alcohol. Look them up and find out who they were. Our reluctance to give people in pain the drugs they need is a continuation of this same policy. When you're doing something stupid, it's helpful to know why you're doing it, so that maybe you can stop doing it.
I'd always known that this tendency to regard suffering as a positive boon to others ran through the stricter Protestant sects, and some Victorian writers, including Charlotte Bronte and Charles Dickens, go into some length describing how this idea suited the purposes of ministers with a streak of cruelty. The Catholics also have a long tradition of "mortification of the flesh", and Pope John Paul II wrote an entire Apostolic Letter on suffering and the need for suffering. The wording is quite similar to quotes from Mother Teresa. Still, this was always presented as being voluntary, and those who tolerated or contributed to the suffering of others were usually regarded as aberrations--in polite company, anyway. But the argument was still making the rounds in Catholic schools when I was young.
But finding it in Mother Teresa's case, where it was policy in an order of 40,000 nuns and volunteers charged with caring for the sick, and realizing how many people saw this and never said a word publicly, and you realize that this is not an isolated aberration. And the pursuance of this same policy, albeit in a milder form, in public medicine should tell you just how far it reaches.
Still, maybe the Eastern Orthodox churches aren't into this, but it certainly seems to run through the Protestant and Catholic churches. That is most of Christianity.
The cycle seems to run like this: Drug A has been found to be "addicting" (for practical purposes, let's define this as "makes you feel really shitty if you stop taking it"), and it has been noticed that people enjoy themselves after taking it. Drug A is therefore declared by the media and government agencies as "evil". (Note that both conditions are necessary and sufficient for evilness: prescription medications that make you feel really shitty if you stop taking them (like certain anti-depressants) aren't evil--presumably because people suffer instead of feeling pleasure. Coffe and likker are OK even though they make some people feel good because they're not addicting (or so they say).
Ok, now we all know that a substance that makes people feel good and that makes them want to keep taking it is a social disaster that puts terrorism, plagues, famine and and the imminent fall of Western culture in the shade, so what do we do? There are, of course, many alternative approaches to this problem but one that has gained some favor is to adopt a new drug, "B" as the "cure" for problem A. This looks good because drug B isn't evil--it hasn't yet experienced the media frenzy that unshakeably convinces the populace that a drug is evil. So drug B is now prescribed for heroin addicts to "cure" them. In the case of Methadone, this was obviously silly because Methadone is just as addicting as heroin, and can make you feel quite nice. In other words, some Methadone patients may be -gasp- enjoying themselves! Methadone does have the advantage of lasting longer than heroin, so it can be handed out to heroin addicts on a once-daily basis, thereby controlling their dosage. But really, this is no different in principle from handing out a day's ration of, say, Dilaudid to the addict. It just looks better, and we all know that looks are all-important.
Of course, Methadone has acquired a definite tinge of evilness, and it's hard to establish a methadone program, and difficult to get into one because the possibility that some individuals may possibly be enjoying themselves troubles the conscience of the media and the politicians.
Now we have Buphrenorphine that is being embraced as the new "cure". Well guess what, addicts aren't going to stop being addicts because they need their daily fix of bupe, and --curses!-- some of them are smiling.
Personally, I think the whole business is silly. I do think there are some people who have a big problem with addiction, but I think the best way to help them is to do what the British have been doing for years, and just prescribe reasonable amounts of the stuff they crave. Maybe bupe will be a better drug, in that accidental or deliberate overdose may be less likely with this drug (it's partly self-limiting because beyond a certain dosage it stops working). But folks, none of these programs is going to work if we Americans don't get over the notion that feeling good by taking certain pharmaceuticals is ipso facto an evil thing.
Great men are almost always bad men--Lord Acton's Corollary