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Morphine Relief Without Addiction?
Posted by
ScuttleMonkey
on Sun Aug 20, 2006 04:29 PM
from the plop-plop-fizz-fizz dept.
from the plop-plop-fizz-fizz dept.
Roland Piquepaille writes "Morphine has been used as a painkiller for decades, if not centuries. Unfortunately for patients, morphine is also an addictive substance. Now, Brigham Young University (BYU) chemists are using a vine plant that grows in Australia to develop a new painkilling molecule, but with fewer side effects. The Deseret Morning News reports that the BYU chemists hope to ease pain with hasubanonine, the synthetic compound they created and which has a similar molecular structure as morphine. Still, more tests need to be done before this natural drug can replace morphine."
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I know what should be used (Score:5, Funny)
Re: (Score:3, Informative)
Re: (Score:3, Informative)
Re:I know what should be used (Score:4, Interesting)
One reason why Coca-Cola can protect the taste of their product from being replicated is that they are one of the few (if not only) US companies that can legally use coca leaves.
Parent
Re: (Score:3, Funny)
Heroin (Score:5, Informative)
Oops! It turned out to be even more addictive, oh well, let's try again. hehe
Re:Heroin (Score:5, Interesting)
Parent
Re: (Score:3, Insightful)
Re: (Score:3, Insightful)
The side effects of nicotine don't seem that bad. (Although inhaling burning hot gasses and all the other particulate crud that are in the typical nicotine delivery system sure don't appeal to me very much.
Morphine's side-effects seem pretty nasty, though.
Morphine is grossly underprescribed, like most pain killers
Agree with you there.
because of the DEA terror
Re:Heroin (Score:5, Insightful)
Oops! It turned out to be even more addictive, oh well, let's try again. hehe
Rinse and repeat with methadone.
Parent
Re:Heroin (Score:4, Interesting)
The cycle seems to run like this: Drug A has been found to be "addicting" (for practical purposes, let's define this as "makes you feel really shitty if you stop taking it"), and it has been noticed that people enjoy themselves after taking it. Drug A is therefore declared by the media and government agencies as "evil". (Note that both conditions are necessary and sufficient for evilness: prescription medications that make you feel really shitty if you stop taking them (like certain anti-depressants) aren't evil--presumably because people suffer instead of feeling pleasure. Coffe and likker are OK even though they make some people feel good because they're not addicting (or so they say).
Ok, now we all know that a substance that makes people feel good and that makes them want to keep taking it is a social disaster that puts terrorism, plagues, famine and and the imminent fall of Western culture in the shade, so what do we do? There are, of course, many alternative approaches to this problem but one that has gained some favor is to adopt a new drug, "B" as the "cure" for problem A. This looks good because drug B isn't evil--it hasn't yet experienced the media frenzy that unshakeably convinces the populace that a drug is evil. So drug B is now prescribed for heroin addicts to "cure" them. In the case of Methadone, this was obviously silly because Methadone is just as addicting as heroin, and can make you feel quite nice. In other words, some Methadone patients may be -gasp- enjoying themselves! Methadone does have the advantage of lasting longer than heroin, so it can be handed out to heroin addicts on a once-daily basis, thereby controlling their dosage. But really, this is no different in principle from handing out a day's ration of, say, Dilaudid to the addict. It just looks better, and we all know that looks are all-important.
Of course, Methadone has acquired a definite tinge of evilness, and it's hard to establish a methadone program, and difficult to get into one because the possibility that some individuals may possibly be enjoying themselves troubles the conscience of the media and the politicians.
Now we have Buphrenorphine that is being embraced as the new "cure". Well guess what, addicts aren't going to stop being addicts because they need their daily fix of bupe, and --curses!-- some of them are smiling.
Personally, I think the whole business is silly. I do think there are some people who have a big problem with addiction, but I think the best way to help them is to do what the British have been doing for years, and just prescribe reasonable amounts of the stuff they crave. Maybe bupe will be a better drug, in that accidental or deliberate overdose may be less likely with this drug (it's partly self-limiting because beyond a certain dosage it stops working). But folks, none of these programs is going to work if we Americans don't get over the notion that feeling good by taking certain pharmaceuticals is ipso facto an evil thing.
Parent
Re:Heroin (Score:5, Interesting)
you might be thinking of methadone to treat a heroin addiction.
No, he WAS thinking of Herion.
The drug chemists were trying minor modifications on the morphine molecule, trying to find something with the pain relief but without the addition. This new one had all the pain killing power, so they tried it on a number of the lab personnel and it didn't give any of them withdrawal symptoms.
So they marketed it as the "Heroine" that would rescue the world from addiction by killing pain without hooking. Only to discover that it hooked at least as well as it cured pain.
Turns out:
a) The body jut converts it back to morphine.
b) There is a small fraction of the population that doesn't get hooked on morphine and its derivatives. And it happened that all the people in the lab they tried it on were members of that subset - a statistically unlikely occurrence.
(There was a theory that such people also gravitate toward research science fields, such as chemistry and medicine, for unknown reasons, though I haven't heard whether this was ever checked out.)
= = = =
One of the most tragic parts of the whole additction / drug war / underprescription of painkillers by doctors for fear of prosecution is that morphine and derivatives, given in appropriate doses for relief from actual severe or chronic pain, apparently DON'T addict. It's a dose spike far above the pain-relief level that sets the hook. (Not that it's easy to tell in chronic pain cases, since the return of the underlying pain is a fine substitute for withdrawal symptoms. But for acute pain tapering the dose - even (especially) by self-administration, also tends to avoid the hook.
But DEA scrutinizes doctor dosing habits and sporadicly prosecutes doctors who prescribe "too much" narcotics. And they don't adequately take into account whether the doctor is a specialist in pain treatment or treatment of illnesses with a lot of associated pain, and thus have an atypical patient mix biased toward need for pain medication and high doses.
So doctors underprescribe. And that leaves many chronic pain sufferers with no alternatives but ongoing excruciating pain, suicide, or recourse to illegal drugs (with their uncertain strengths, and high cost requiring IV administration with its sudden onset, leading to dose spikes and addiction).
Parent
Re:Heroin (Score:5, Insightful)
So doctors underprescribe. And that leaves many chronic pain sufferers with no alternatives but ongoing excruciating pain, suicide, or recourse to illegal drugs (with their uncertain strengths, and high cost requiring IV administration with its sudden onset, leading to dose spikes and addiction).
The really sad thing is that for those in chronic pain, addiction isn't really much of a risk considering that the pain itself will make sure that they NEED to take whatever painkiller they have regularly anyway. Reluctance (on the government's part anyway) to give terminal patients all they want is also baffling to me.
Parent
Re: (Score:3, Funny)
Because it's a drug, and as we all know, drugs cause terrorism!!!
Re:Heroin (Score:5, Insightful)
I wish it were only Puritans, but this kind of lunacy seems to permeate most of Christianity. Christoper Hitchens wrote a book entitled The Missionary Position [ffrf.org] which included eyewitness accounts of people who worked with Mother Theresa. Apparently, Mother Theresa refused to use pain killers stronger than aspirin, even for terminal patients who were writhing with pain from cancer. It's not like she couldn't afford them; her order had fifty million in the bank, and she wasn't far from Afghanistan--morphine would have been dirt cheap. Her rationale was that suffering brought you closer to Christ who suffered on the cross. So hey, pain is good, painkillers are evil, got it?
At some point, a religious consolation which was supposed to make people feel better about their pain (I'm sorry we can't help your pain, but something good may come of it) became twisted into a message that pain was good for the soul (which is why the Inquisitor needs all these implements of torture.) But don't try to understand it, it's a mystery...
Parent
Re:Heroin (Score:5, Interesting)
I'd always known that this tendency to regard suffering as a positive boon to others ran through the stricter Protestant sects, and some Victorian writers, including Charlotte Bronte and Charles Dickens, go into some length describing how this idea suited the purposes of ministers with a streak of cruelty. The Catholics also have a long tradition of "mortification of the flesh", and Pope John Paul II wrote an entire Apostolic Letter on suffering and the need for suffering. The wording is quite similar to quotes from Mother Teresa. Still, this was always presented as being voluntary, and those who tolerated or contributed to the suffering of others were usually regarded as aberrations--in polite company, anyway. But the argument was still making the rounds in Catholic schools when I was young.
But finding it in Mother Teresa's case, where it was policy in an order of 40,000 nuns and volunteers charged with caring for the sick, and realizing how many people saw this and never said a word publicly, and you realize that this is not an isolated aberration. And the pursuance of this same policy, albeit in a milder form, in public medicine should tell you just how far it reaches.
Still, maybe the Eastern Orthodox churches aren't into this, but it certainly seems to run through the Protestant and Catholic churches. That is most of Christianity.
Parent
Shipman Effect (Score:3, Informative)
Re: (Score:3, Insightful)
HTTP://Ron.Dotson.org/pic/Doonesbury.gif
Actually, Most People Don't Become Addicted (Score:5, Informative)
This is misleading. Actually, the vast majority of individuals who use opioids do not develop addiction. Everyone develops physical dependence and it's important to understand the difference. While physical dependence requires that long term opiate users taper thier dose of a long period of time, addiction (psychological dependence) occurs in only a few percent of opiate users.
Opiate addiction is similar to alcoholism. The vast majority of alcohol users will never experience addiction disorder.
For two years I took 60mg of time release morphine (Avinza) for fibromyalgia. Personally, it was much more difficult to quit drinking coffee than it was to taper off morphine (using oxycodone to taper).
Parent
Re: (Score:3, Informative)
they tried it on a number of the lab personnel and it didn't give any of them withdrawal symptoms.
These early drug studies were limited by a very poor understanding of the nature of addictive behavior. Almost certainly the lab personnel did exhibit the signs and symptoms of physical withdrawal from the opiate, but these weren't recognized as such. Opiate withdrawal symptoms make one feel grumpier and more irritable, and have some signs like a mild flu, and that's it. Of itself, the physical withdrawal fr
When genuine physical pain is involved (Score:3, Interesting)
While recovering from the surgery that bought her a couple of extra years of life, my mother had a patient-controlled Demerol pump. The fascinating thing about those is not that the patients get (duh) better pain control but that their total narcotic consumption is actually lower than when the medical people decide how and when to dose.
Re:Heroin (Score:4, Informative)
The actual addiction part is not just from what happens to various levels of chemicals when you apply and then remove the drug, but to a larger extent is caused by what actually happens to the number/density of receptors themselves. A difficult problem to combat.
The problem, as many other posts here about heroin and morphine allude to, is that any compound that works via these receptors will cause similar addictive effects. The only way to avoid that it to change the way that the drug targets receptors. But, if you do that, then it's not really fair to have this article. i.e., it would then make about as much sense to say "Pepto Bismol relieves stomach pain without the addictive effects of heroin!" In other words - duh! They're not the same thing.
The reason the mu receptor is a common pain medicine target is because it is SO effective at block pain signals. But, as with so many other things posted here, there is no free lunch. You want big time pain relief? Mu receptors are the way to go. But that means issues with addiction/withdrawal/etc.
Parent
Re: (Score:3, Interesting)
It would be more acurate to say that heroin was self-prescribed to anybody with a Sears Catalog, even came with the syringe.
Next up: Fire that doesn't burn you! (Score:5, Informative)
Re:Next up: Fire that doesn't burn you! (Score:5, Informative)
Don't confuse addiction with habit. Addiction is a physical dependency and that aspect doesn't necessarily have any relation to its analgesic effect. Aspirin has analgesic properties, but NO addictive qualities.
What makes opioids addictive is unknown. What makes them analgesic is, to some degree, understood. The two may be linked, but because something is analgesic does not make it addictive. It may be "habit-forming", on the other hand. Marijuana, for example, can be habit-forming, but it is not addictive because one does not develop a physical dependence on the presence of the drug in their system.
Parent
Re:Next up: Fire that doesn't burn you! (Score:5, Informative)
Marijuana is a non sequitur, he's talking about central nervous system analgesics.
Try that one again, this time, with reading comprehension.
For reference:
Asprin: peripheral analgesic
Heroin: central analgesic
Ibuprofen: peripheral analgesic
Oxycodone: central analgesic.
See a pattern here? pethidine, oxycodone, hydrocodone, diamorphine, fentanyl, basically anything that is inhibited by a mu antagonist is going to get you addicted if you take it long enough.
Parent
not only that... (Score:5, Interesting)
(1) The BYU chemists don't know if the compound has painkilling properties at all. It's the mirror image of another molecule which is known not to be a painkiller. The mirror image is similar to morphine, so they hope it might have the painkilling properties of morphine. But it's painkilling properties are at this point entirely theoretical.
(2) They have no clue whatsoever whether, if it has painkilling properties, it is less addictive than morphine. It just as easily be more addictive. All they know is, while it looks like morphine, it isn't exactly morphine, so it will probably have slightly different properties.
(3) And of course, they have no idea whether the new molecule would have other, less desirable differences from morphine -- like being a deadly poison to the kidneys. Whether the stuff could even be safely taken by humans is still unknown.
In short, the summary on this article wildly exaggerates its content.
Parent
Re: (Score:3, Interesting)
That said, there are a variety of morphine-derived drugs that exhibit painkilling properties and the properties that make morphine painkilling are fairly well understood. Drug development isn't quite as m
heard it before (Score:2, Funny)
Morphine doesnt stop pain (Score:4, Informative)
as someone who was recently in hospital and had morphine (and as a person who has done just about every drug there is) i can say it doesnt actually _stop_ the pain it just makes you not care about it, but it was still there even when wasted out of my skull it just makes you not care
now a painkiller that would actually take away pain would iam sure be welcomed
Re:Morphine doesnt stop pain (Score:4, Informative)
As someone who was also recently in the hospital, and also recently had morphine, it most definitely takes away the pain.
Parent
Hardly a new concept (Score:3, Informative)
"...there is always soma, delicious soma..." (Score:2)
Welcome, to a A Brave New World [wikipedia.org]!
Oh wait, there's already a drug marketed under the name of Soma [wikipedia.org]? Damn!
Ryan Fenton
Natural drug? (Score:3, Insightful)
Re: (Score:3, Informative)
I see addicts. (Score:5, Funny)
chronic pain (Score:5, Insightful)
Re: (Score:3, Insightful)
The formal definition of addiction includes a criterion of consuming more of the substance than is medically justified. For example, it would be stupid to talk about diabetics being "addicted" to insulin. Similarly for pain control in the terminally ill or even in survivable cases like severe burns. My late mother got the morphine she needed.
Anyone who talks about "addiction" in cases like that or withholds medicat
Medical comments: (Score:5, Informative)
Morphine is a natural drug, it comes from a plant. Cocaine, digitalis, aspirin and many other drugs are also natural.
If the new drug is related to morphine I take that to mean it will work on the same receptors in the brain.
If it does, it will have a similar side effect profile: constipation, nausea, respiratory depression and probably addictive potential.
To me, this is just a "me too" drug like Tagamet/Zantac/Pepcid that all work the same way on the same receptors.
Interestingly, there is no profit margin in simple morphine. The cost to the hospital for an ampule that would relieve severe pain is on the order of $1.
The DEA paperwork is a bigger cost to a hospital!
The biggest long term problem for people who take morhine (or heroin in the UK or oxycontin or any drug in this class) is constipation.
Cancer patients don't have to worry about addiction.
Re: (Score:3, Interesting)
Not exactly. Peripheral opioid antagonists, like methylnaltrexone, can neutralise effects like constipation without affecting CNS sctivity. In theory, even respiratory depression may be averted since it's a different MOR subtype involved in that autonomic role, compared to the analgesic circuit (although I'm not aware of any products so far).
Re:Medical comments: (Score:4, Informative)
Since we haven't yet invented a practical form of transmutation or energy-matter conversion, everything is 'natural', in that it is made from things extracted from plants, animals, or rocks. 'Natural' is an emotive word with no scientific meaning.
Somewhat more to the point, drugs roughly equivalent to morphine (endorphins) are naturally produced by the body on its own, without any external intervention. You can even get addicted to them, if you can be bothered to engage in the heavy exercise necessary (many serious athletes become mildly addicted, and yes, it's real addiction - they show physical withdrawal symptoms if they stop exercising regularly, just like with any other opiate, and can occasionally require medical treatment to manage this if an injury prevents them from training). In no sense can you call an opiate, or any quantity of an opiate, 'unnatural'. It's a fundamental part of how the human body/mind operates (including everything from chocolate to orgasm).
People need to find something less pointless to talk about than whether something is 'natural'.
Parent
Relief (Score:5, Funny)
Do editors read? Roland Piquepaill gets a pass? (Score:5, Informative)
In the next to last sentence: "the synthetic compound they created".
In the last sentence: "this natural drug".
Ummm, those two phrases are the complete opposite of each other...
From the F'ing article:
Mirror image of the "natural one". Sounds like a "synthetic compound" to me...
Across the Big Pond (Score:4, Informative)
Obligatory editor joke (Score:3, Funny)
Talk about self contradiction...
Puhleease: seperate blog for Roland Piquepaille (Score:4, Insightful)
I read
Roland Piquepailles submissions are usually vague quasiscience or fiction.
It seems this last one "Morphine Relief Without Addiction?", is just some graduate students learning to synthsize a compound with no empirical data it is any more useful than sand. I quote: "The *idea* is that we *can* send it to NIH to test to see if it kills pain"
You should mod this up if you agree or mod away as flamebait/offtopic/troll if you dont agree, but at least mod it.
Addiction not a problem for most morphine users (Score:5, Interesting)
Addiction to psychoactive drugs arises from the psychological instead of the physiological effects of the drugs. New drugs that offer the the same psychological effects as traditional drugs will present most of the same addiction issues.
Source with Images (Score:5, Informative)
Distinction between "addiction" and "dependance" (Score:3, Interesting)
That said, such a drug is already on the market, Tramadol [wikipedia.org]. Tramadol delivers on it's promise of pain relief without dependance, however, it does not have the potency. Tramadol only exhibits about 10% of the analgesic effect of morphine.
If this new drug offers relief from moderate to severe pain without the physical issues caused by opiate agonists, it would be a welcome breakthrough. Many chronic pain sufferers (myself included) spend their lives dependant on medications that cause awful side effects if abruptly discontinued. A pain reliever that does not create this problem would certainly be useful in treating legitimate pain.
But, I suspect the title of this posting and TFA itself, are somewhat misleading - there is nothing that can alleviate the psychological problem of addiction in those seeking to abuse medications.
Morphine and Heroine addiction are now curable (Score:3, Informative)
Opiates in general work because they are similar to endorphins. Endorphins are a chemical in our system that provides a pleasurable sensation when we're doing something that is contrary to energy efficiency, and yet is beneficial to either individual or genetic survival. Exercise, sex, and "thrilling" activities are the primary examples of this, being called "runner's high" "afterglow" for the first two.
Any time we perform a behavior and it results in us having opioids in our system (endorpin, morphine, whatever), the neural links that were recently fired get stronger -- take less effort to fire. This isn't just a matter of "hey, that felt good, I think I'll do it again", it's a matter of reinforcing the neural linkage that recently occured, and this makes us consider those paths to be more favorable when examining our options in the future. This results in opioid addiction, and is also largely responsible for alcoholism. Alcoholics are mostly people whose system produces an abundance of endorphins.
If you don't have a medical background the cure may seem a little anti-intuitive, but medical experts that I describe it to generally nod their head and say "yea, that makes sense". When we perform a behavior and get flushed with opioids, the connections get stronger. When we perform a behavor and DON'T get flushed with opioids, the connections get weaker, returning to their normal state. What this means about a cure is against a lot of people's grain. First, you take something that blocks your opioid uptake. Endorphin antagonists are commonly sold under the names of ReVia, naltrexone, noloxone and nalphemene. They're generally used to ease opiate withdrawl symptoms and to treat alcoholism. Then you feed your addiction.
In case you missed it, I'll say it again. If you perform the behavior (smoking opium, shooting up heroin, get drunk, whatever) and your body doesn't get the opioid flush, then your body unlearns the addiction. For alcoholism, most patients regain the upper hand on their urges after two or three weeks, and can drink socially without fear of overdrinking or going on a binge after about three months. For this to occur, however, the person MUST perform their addictive behavior, and it works best if they perform their habits when and where they normally do.
There is a lot of information about this. If you're interested, the best place to start is probably the Wikipedia entry on the Sinclair Method [wikipedia.org].