Pain therapy – Are there new options on the horizon?

This article reviews the role of analgesic drugs with a particular emphasis on opioids. Opioids are the oldest and most potent drugs for the treatment of severe pain, but they are burdened by detrimental side effects such as respiratory depression, addiction, sedation, nausea, and constipation. Their clinical application is undisputed in acute (e.g., perioperative) and cancer pain, but their long-term use in chronic pain has met increasing scrutiny and has contributed to the current opioid crisis. We discuss epidemiological data, pharmacological principles, clinical applications, and research strategies aiming at novel opioids with reduced side effects.
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research

Related Links:

Purpose of review Opioids are potent drugs for the treatment of severe pain, but they are burdened by detrimental side-effects, such as respiratory depression, addiction, sedation and constipation. Their clinical application is undisputed in acute (e.g. perioperative) and cancer pain, but their use in chronic nonmalignant pain has met increasing scrutiny and has contributed to the opioid crisis. Thus, novel analgesics with reduced side-effects are badly needed. Recent findings Current research topics include enkephalinase inhibitors, allosteric and multivalent ligands, biased opioid receptor signaling and selective ac...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: NON-MALIGNANT DISEASES: Edited by Anthony H. Dickenson and Kirsty Bannister Source Type: research
CONCLUSION: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. PMID: 31222410 [PubMed - as supplied by publisher]
Source: Schmerz - Category: Anesthesiology Authors: Tags: Schmerz Source Type: research
How Bad Is Fentanyl? Fentanyl is an extremely dangerous synthetic opioid. Unlike some other opioids that occur naturally, it is man-made for the purpose of helping aid people suffering from extreme pain. It can be administered for recovery after surgery, during cancer treatments or for recovery after a painful injury. The Drug Enforcement Administration (DEA) classifies fentanyl as a Schedule II controlled substance. This means that it is legal for medical use, however, it has an extremely high potential for abuse and addiction. Understanding Fentanyl Significantly stronger than morphine or oxycodone, Fentanyl can be fatal...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction to Pharmaceuticals Drug Rehab Information Drug Treatment Heroin Painkiller Substance Abuse Synthetic fentanyl prescription drug abuse prescription drug addiction prescription drug detox prescription drug use p Source Type: blogs
CONCLUSION: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. PMID: 30645691 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
This article reviews pharmacological principles and research strategies aiming at novel opioids with reduced side effects. Basic mechanisms underlying pain, opioid analgesia and other opioid actions are outlined. To illustrate the clinical situation and medical needs, plasticity of opioid receptors, intracellular signaling pathways, endogenous and exogenous opioid receptor ligands, central and peripheral sites of analgesic and side effects are discussed. Expert opinion: The epidemic of opioid misuse has taught us that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that co...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
CONCLUSIONS: A number of adverse events, including serious adverse events, are associated with the medium- and long-term use of opioids for CNCP. The absolute event rate for any adverse event with opioids in trials using a placebo as comparison was 78%, with an absolute event rate of 7.5% for any serious adverse event. Based on the adverse events identified, clinically relevant benefit would need to be clearly demonstrated before long-term use could be considered in people with CNCP in clinical practice. A number of adverse events that we would have expected to occur with opioid use were not reported in the included Cochra...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
  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
Follow me at @mallikamarshall If your doctor told you that she was giving you a placebo and that it would help you, would you believe her? As it turns out, based on new research, maybe you should. Placebos are often considered “fake” treatments. You may have heard them described as “sugar pills.” They usually take the form of pills, injections, or even entire procedures that are used in clinical trials to test “real” treatments. For example, one group of study participants is given an active drug and another group is given a placebo, which looks exactly like the active medication but is ...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Complementary and alternative medicine Pain Management Source Type: news
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. E...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Health Addiction Arthritis Back Pain Cancer Migraines Pain Management Behavioral Health chronic pain managing pain Source Type: news
Chronic pain is a major public health problem, which is estimated to affect more than 100 million people in the United States and about 20–30% of the population worldwide. The prevalence of persistent pain is expected to rise in the near future as the incidence of associated diseases (including diabetes, obesity, cardiovascular disorders, arthritis, and cancer) increases in the aging U.S. population. Opioids are powerful analgesics that are commonly used and found to be effective for many types of pain. However, opioids can produce significant side effects, including constipation, nausea, mental clouding, and respira...
Source: Psychology of Pain - Category: Psychiatrists and Psychologists Source Type: blogs
More News: Addiction | Cancer | Cancer & Oncology | Chronic Pain | Constipation | Depression | Epidemiology | Pain | Respiratory Medicine | Rheumatology