Non-Addictive Pain Medication May Halt Opiod Epidemic
The first shaky steps toward a safer, non-addictive, opioid painkiller may have just been taken by a team of researchers from Wake Forest University in North Carolina.
The researchers synthesized a novel opioid based on a preexisting drug, dubbing it BU08028. They then tested out their creation on monkeys, with the drug passing these initial trials with flying colors. BU08028 provided long-lasting painkilling effects, but without the addictive properties inherent to other drugs like cocaine or the opioid remifentanil. It also didn’t cause other common side effects seen with opioid use, such as slowed breathing, incessant itching, and cardiovascular problems.
Though the results, published Monday in Proceedings of the National Academy of Sciences, represent the earliest stages of research, the team is hopeful that their discovery can spurn the development of “safe and potentially abuse-free opioid analgesics.”
BU08028 is derived from buprenorphine, which is itself used to treat opioid addiction, oftentimes in conjunction with other drugs like naloxone. Buprenorphine works differently than the typical painkillers associated with addiction, such as morphine and heroin. The latter opioids are called full agonists, which means they completely activate specific receptors in the brain responsible for the drug’s various effects, including the telltale high and dependence experienced by some users. Partial agonists like buprenorphine don’t fit these receptors perfectly so they’re less potent and can be used to treat moderate levels of pain. Importantly, they also negate full agonists when taken at the same time, allowing them to become a tool against opioid abuse.
BU08028 was designed to be a souped up version of these partial agonists, particularly in its effectiveness as a painkiller. Other scientists are more doubtful about the drug’s long term future, however.
"While the findings are of interest, animal studies are notoriously poor at predicting clinical outcomes in humans," Dr. Caleb Alexander, an associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore, told Healthday. "Don't hold your breath waiting for the first addiction-free opioid. There is not a product coming down the pike anytime soon with such characteristics."
There’s also the likely possibility that BU08028 wouldn’t be effective for certain types of pain that more powerful opioids are currently used for. And while it could very be well safer than the drugs we have now, it wouldn’t be harmless. Even buprenorphine can cause headache, stomach pain, vomiting, and a laundry list of other side effects.
In the best case scenario, though, BU08028 and similar drugs like it may someday help us wean off more dangerous opioids while still letting us live relatively pain-free lives.
Source: Ding H, Czoty P, Kiguchi N, et al. A novel orvinol analog, BU08028, as a safe opioid analgesic without abuse liability in primates. Proceedings of the National Academy of Sciences. 2016.