The Quest for Safer Opioid Drugs | The Scientist Magazine

Opioid drugs are well-established double-edged swords. Extremely effective at analgesia, they cause an array of harmful side effects throughout the body, including itching, constipation, and respiratory depression —the slowed breathing that ultimately causes death in overdose cases. What's more, the body's interaction with opioids is dynamic: our receptors for these compounds become desensitized to the drugs' activity over time, requiring ever larger doses to suppress pain and eventually provoking severe dependence and protracted withdrawal.In the past few years, these side effects have plagued growing numbers of US citizens, plunging the country into the throes of a devastating opioid crisis in which nearly 100 people die from overdoses every day. Even so, opioids are still among the most effective pain-relief options available."Over hundreds of years, [opioid receptors] have remained a target," says Laura Bohn, a biochemist at the Scripps Research Institute in Jupiter, Florida."Therapeutically, it works."Since the early 2000s, intriguing evidence has emerged suggesting that opioids' useful properties could be separated from their harmful attributes. (See"Pain and Progress," The Scientist, February 2014.) In 2005, Bohn, then at the Ohio State University College of Medicine, and colleagues showed that shutting down one of the signaling pathways downstream of the opioid receptor targeted by morphine not only amped up the drug...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs

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​​BY STUART ETENGOFF, DO, &ABDULLAH ​BOKHARI​, AB, DOA 20-year-old Caucasian man presented via EMS with a chief complaint of withdrawal from ketamine and secondary complaints of abdominal pain, blood in his urine, and painful urination with urgency for two days.He said he had been using ketamine intravenously daily for the past five days, up to 35 grams over the past week. His last use was 24 hours prior to presentation to the ED. He stated that he had been using ketamine regularly for four years and that he has used it intravenously, orally, and intranasally.He reported a history of ADHD and a family hist...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Abstract Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment. As a partial opioid agon...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Okay, everyone knows smoking is bad for you, the number one cause of preventable death in the US and the world, a direct cause of lung and heart disease and cancer… et cetera. So let’s get right down to the nitty-gritty: quitting smoking is tough. What can people do to quit? To answer this question, I spoke with my colleague Nancy Rigotti, MD. Dr. Rigotti is director of the Massachusetts General Hospital Tobacco Research and Treatment Center. She has extensively researched nicotine and tobacco, evaluated public policies on tobacco, contributed to US Surgeon General’s Reports, and authored clinical guidel...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Heart Health Lung disease Prevention Smoking cessation Source Type: blogs
The first principle of medicine is to “do no harm.” Over the past two decades, the medical community has attempted to honor this principle by treating patient pain with opioid prescriptions. Unfortunately, these good intentions have driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States. Inpatient overprescription of opioids such as morphine, oxycodone, and hydrocodone happens in a variety of ways—doctors prescribe too many doses, too large a dose, or allow patients to continue opioid treatment for too long. And many times, doctors could a...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Health Professionals Hospitals Population Health hospital-acquired condition opioid epidemic overprescribing opioids pain management Source Type: blogs
After a fairly slow 2016, the United States Food and Drug Administration’s (FDA) Office of Prescription Drug Promotion (OPDP) issued a quick burst of letters in the span of nine days in December. This flurry of activity more than doubled the enforcement letters that had been issued up to that point in the year. Although there was an apparent increase in enforcement activity in December (perhaps related to the new Administration and the mark the old Administration wanted to leave on the industry), the type of activity and the nature of Draft Guidances issued in 2017 prior to the Trump Administration taking office ind...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs
  RX PAD With the death of the entertainer Prince attributed to a fentanyl overdose, and new FDA warnings, opioids have been making headlines. Since the most common reason patients visit the emergency department is for pain, it is not surprising that emergency physicians prescribe and administer medications such as oxycodone on a daily basis. Here are some of the basics about how oxycodone works, and also the reason why chronic users may be at even higher risk of unexpected respiratory depression. HOW IT WORKS: Oxycodone is a semi-synthetic opioid with analgesic properties. Oxycodone binds to mu, kappa, and delta opio...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news
Authors: Harned M, Sloan P Abstract INTRODUCTION: The benefits of opioid therapy must be balanced by any adverse effects. In recent years, prescription opioids have been increasingly prescribed, but have also been associated with increased abuse, overdose and death. Areas Covered: This review will categorize the common risks of opioid administration. Recognized adverse effects of opioid therapy include constipation, tolerance, endocrinopathies, sleep disorders, cognitive effects, respiratory depression, overdose and addiction. Studies have shown that there is increased risk of overdose and death with higher daily o...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
This post originally appeared on The Timmerman Report and then ran on Venture Valkyrie. I have a new favorite TV show: Join or Die with Craig Ferguson. Ferguson is a irreverent, sometimes raunchy Scottish comedian who used to host the Late Late Show alongside his skeleton puppet sidekick Geoff.   Join or Die airs Thursdays at 11 pm on the History Channel, which is your first clue that this isn’t your run of the mill late night talk show. The premise of Join or Die, named after Ferguson’s tattoo, is that four people, a random assortment of comedians, actors, historians and scientists plus Ferguson, deb...
Source: Disruptive Women in Health Care - Category: Consumer Health News Authors: Tags: Consumer Health Care Quality Source Type: blogs
The prescription opioid crisis of overdosing and overprescribing has reached epic proportions, according to the North American media. Just last week, we learned that 91% of patients who survive opioid overdose are prescribed more opioids! The CDC calls it an epidemic, and notes there's been “a 200% increase in the rate of overdose deaths involving opioid pain relievers and heroin.” A recent paper in the Annual Review of Public Health labels it a “public health crisis” and proposes “interventions to address the epidemic of opioid addiction” (Kolodny et al., 2015).In the midst of this publ...
Source: The Neurocritic - Category: Neuroscience Authors: Source Type: blogs
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