In a country plagued by the opioid crisis, the race is looking for novel solutions to control pain. One in five Americans experiences some form of chronic pain.
Opioids are powerful pain relievers prescribed by a doctor. Because they are highly addictive, prescription opioids have sparked a nationwide epidemic that kills 128 people each day, according to the Centers for Disease Control and Prevention. To avoid the potential dangers of prescription opioids for pain management, many doctors are turning to new medications called “neuromodulators,” some of which are also used to treat depression. These medications, which include gabapentin, pregabalin, and duloxetine, affect how the nervous system perceives pain rather than directly attacking it.
Although they are effective for some, they are not the right treatment for everyone.
“What happens not only with medications but with almost all our pain treatments [is that] about 30 to 40% of people get better with any treatment, “said Dr. Ajay D. Wasan, professor and vice president of the University of Pittsburgh School of Medicine and president of the American Academy of Pain Medicine.
PHOTO: A person with back pain. (FREE PICTURES / Getty Images)
While an increasing number of scientists are studying alternatives to opioids, it is unlikely to find a single pill that relieves all pain. Instead, researchers and doctors believe that medicine is on the cusp of a revolution in the way providers treat pain. They predict that pain management will shift toward personalizing treatment for each patient rather than prescribing a type of medication such as a panacea.
Wasan said he is optimistic about the future, with several new treatments for pending pain that could expand options for one in five Americans experiencing chronic pain.
His hope is that with additional combinations of research and therapy, “perhaps 50 to 60% of patients will be able to respond to a particular treatment.”
“As a prescriber, you want a variety of options,” said Dr. Rebecca Baker, director of a major federal government research effort called HEAL (Helping to End Addiction Over the Long Term) that focuses on alternative ways of help patients deal with pain.
“There are many different pain conditions and each one needs to be treated differently,” Baker said. “Right now, we don’t have a lot of options.”
HEAL, sponsored by the National Institutes of Health, has identified several medications with the potential to treat opioid addiction or serve as alternatives to opioids, as well as multiple non-drug therapies to help people manage pain.
“The goal of the NIH HEAL initiative is to provide scientific solutions to the national crisis of opioid abuse, overdose and addiction,” said Baker.
Since its founding in 2018, HEAL has contributed $ 500 million annually to more than 400 research projects.
Baker says the NIH has invested in a wide range of promising pain treatments. Specifically, scientists are studying a type of medication called antibody therapy that binds to and therefore blocks pain signals from the body.
There are other medications designed to attack every part of the nervous system, from its genetic material to electrical signals that travel throughout the body and brain, recording pain as a sensation.
Meanwhile, some companies are taking a different approach, trying to develop medical-grade versions of one of the oldest pain relievers in history: cannabis.
PHOTO: A doctor holds medical marijuana in one hand and pills in the other. (FREE PICTURES / Getty Images)
The hope is that cannabinoids are effective but not addictive for patients with chronic pain, according to Greg Gorgas, CEO of Artelo Biosciences, an investigational cannabis company. But cannabinoids and other pharmaceutical options have yet to be tested in clinical trials, and may be only part of the solution.
Baker also says there is promising research on new medical devices that treat pain, including an ultrasound that stimulates the body’s nervous system to interrupt pain transmission. But according to Baker, pain research extends far beyond drugs and medical devices.
Scientists are also studying mindfulness meditation, behavioral therapy, physical exercise, and group rehabilitation to control pain.
“We need a better understanding of the biological and genetic bases of these differences and incorporate them into our research and development plans,” said Gorgas.
Someday soon, Baker said, “pain [will be] treated like other health conditions. . . that means looking at the person as a whole and having a number of options to offer people in pain and then working with them to find the treatment approach that works best for them. “
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