The need to develop safer alternatives to opioids has come to the forefront opioid epidemic. New research was done with botulinum toxin show hope as a proven safe and effective treatment for chronic pain.
The National Institutes of Health (NIH) estimates that approximately 25.3 million Americans suffer from long-term pain and have chronic pain. Opioids, like hydrocodone and oxycodone, became the primary treatment for chronic pain in the 1990’s. Americans are believed to get more prescriptions for opioids than any place else in the world. The epidemic has become a national crisis resulting in misuse, overdose, and death.
Abused opioids include such drugs as:
These drugs are susceptible to misuse due to several factors. Problems with opioids as pain relievers include:
- long-term use results in tolerance to the drug
- opioids can increase body sensitivity to pain
- they raise the risk of chronic pain for the long run
High doses of opioid have side effects that can have detrimental effects, such as respiratory depression. These side effects include:
- nausea and vomiting
- breathing difficulty
- mental disturbance
There are few acceptable uses for opioids such as chronic and terminal illness and disease. These medicines require close monitoring and should only be taken when absolutely necessary. Self-monitoring and contracts with the medical prescriber are a part to managing chronic pain not related to cancer.
Acceptable uses of opioids include:
- cancer with severe pain
- Chronic pain not caused by cancer
- the need for around the clock pain relief when another treatment is not working.
UK researchers are exploring a new type of opioid that has the potential to relieve pain without causing breathing difficulty or increasing abuse potential. The compound is called by its chemical name BU08028. The new drug has successfully relieved pain in rhesus macaque monkeys.
In addition, botulinum research has broken down the molecule and rebuilt it with an opiate called dermorph. The compound has been named derm-bot or sp-bot. The compound has been used to turn off pain signals that travel the spinal cord to the brain. Botulinum blocks the neurotransmitter that carries the signal to the brain. Derm-bot has shown promise in studies with relieving pain and inflammation. The drug avoids tolerance, overdose and addiction factors normally associated with repeated opioid use.
These new drugs are still in the testing and research phase and there is currently no established dates for human trials or release for prescribing. Other than this, there are no “new” drugs on the market to treat long-term and chronic pain.