Scientists Just Solved a Major Piece of the Opioid Puzzle | WIRED
When it comes to tackling the opioid crisis, public health workers start with the drugs: fentanyl, morphine, heroin. But biochemists have a different focus: Not the opioids, but opioid receptors —the proteins the drugs latch onto within the body.These receptors embed themselves in the walls of cells throughout the brain and peripheral nervous system. There, they serve as cellular gatekeepers, unlocking not just the painkilling properties for which opioids are prized, but the severe, addictive, and often lethal side effects that, in 2016, contributed to the deaths of more than 50,000 people in the US.But it doesn't have to be that way."The idea in the field for many years has been to make an opioid that provides beneficial analgesic properties without the harmful side effects," says pharmacologist Bryan Roth, a physician researcher at University of North Carolina School of Medicine. Design a drug that kills pain, not people.To build that drug, though, researchers need to know the shape of its receptor. This week in the journal Cell, Roth and nearly two dozen of his colleagues report for the first time the structure of the kappa opioid receptor while it's bound to a drug molecule, a discovery that could accelerate the discovery of less-addictive —and less deadly—opioids.More …https://www.wired.com/story/scientists-just-solved-a-major-piece-of-the-opioid-puzzle/
Resumo A adic ção sexual pode ser definida como quadro psicopatológico no qual o sexo é buscado de forma incontrolável, desenfreada, a despeito dos prejuízos emocionais, sociais e profissionais que suscita no cotidiano do adicto. Após o frenesi, a excitação e a adrenalina em ceder aos próprios impulsos urgentes e vorazes, o sex-addict percebe-se incapaz de gerenciar suas atuações sexuais, sendo consumido por sentimentos de vazio, fracasso e desespero. A problemática do prazer sexual “ al ém do princípio de prazer ...
The rise in the use of opioids has been accompanied by escalating rates of prescription opioid misuse and addiction in patients with pain. Research has shown that opioid craving is a robust determinant of prescription opioid misuse. There is reason to believe that hedonic feelings associated with opioid use (e.g., pleasure, satisfaction) could also contribute to opioid misuse. However, this has yet to be examined in patients with pain. In this longitudinal study, the first objective was to examine the association between opioid-related hedonic feelings and prescription opioid misuse in patients with chronic pain.
Approximately 70% SCI patients report chronic pain, with a third characterizing their pain as debilitating. SCI-NP accompanies 40%-60% of SCI cases and is regarded as more severe than nociceptive pain. SCI-NP remains minimally responsive to existing pharmacological and nonpharmacological treatments. Pharmacological agents (e.g., antidepressants, antiepileptics, opioids) provide only a third of patients ’ 50% pain reduction and present significant side effects including constipation, toxification, and addiction.
Before the height of the opioid crisis, research had well-established older Blacks ’ reluctance to use opioids due to concerns about side effects, addiction, and overdose. Our study found that 30% of Blacks used opioid medications within the past 30 days to manage joint pain. Given this proportion of users, we investigated demographic, social, clinical, and behavioral patterns d istinguishing opioid consumers and non-consumers. Descriptive statistics, chi-square, one-way ANOVA, and qualitative content analysis summarize data for community-dwelling Black adults (≥50 years age) with symptomatic osteoarthritis.
Chronic low back pain symptoms are extremely common among Iraq/Afghanistan-era Veterans. However, pharmacological management for pain is frequently suboptimal, and many Veterans experience persistent and unalleviated pain symptoms and/or intolerable side effects to pain medications. Current medications such as opioids that are frequently used to treat chronic pain symptoms have side effect risks such as respiratory depression, addiction, sedation, and potentially lethal interactions with other drugs. There is thus an acute and immediate need for the development of effective, safe, and non-habit-forming pharmacologica...
The development of analgesic tolerance to opioid pharmacotherapies presents a persistent issue in the treatment of chronic pain, resulting in dose escalation and increased risk for dependence and respiratory depression. Recent studies have demonstrated the involvement of peripheral opioid receptors in the development of opioid tolerance to classical opioids like morphine and oxycodone. There have also been reports of differences in opioid analgesia, tolerance and addiction between males and females.
The incomplete understanding of chronic neuropathic and inflammatory pain mechanisms poses a major challenge for the development of new, non-addictive pain medications. Cross-species differences in pharmacological responses and analgesic effects lead to poor translation of preclinical animal models to clinical studies in humans. We have developed methodologies for the isolation of human sensory neurons, from organ donors, which allow for ex-vivo studies of sensory neurons physiology and pharmacology.
Opioid addiction is the number one health care issue in the United States with spinal ailments the leading medical condition associated with opioid addiction. In the literature, patients with chronic pain syndrome and opioid addiction going for spine surgery have poor post-operative clinical outcomes and likely to be on opioids for life. Current evidence-based methods to optimize patients prior to spine surgery have been: 1) transition from opioids to non-opioid medications, 2) cardiovascular exercise program, 3) smoking cessation, 4) alcohol cessation, and 5) psychotherapy to treat mood and maladaptive pain behavior.
PURPOSE: The Institute of Medicine states that a health professionals ’ primary role for chronic pain should be guiding, coaching, and assisting patients with day-to-day self-management. However, providers often lack the time and training to perform this role, and there is limited research on self-management approaches. We propose providers use a transformative ca re model that integrates robust patient training with evidence-based treatments using tele-coaching and technology to improve long-term outcomes and health chronic pain.