Followers of my blog and Facebook page, David Heitz Health, ask me all the time: Why aren’t there any alternative to opioids that actually work to relieve pain just as well?
I have been saying there are a few things in the works, and I have promised to follow up when there is news to share. That day finally has dawned.
Research published this week in Proceedings of the National Academy of Sciences showed that a new compound, BU08028, works to relieve pain in monkeys without harmful side effects such as addiction or overdose. In fact, even at doses ten to 30 times larger than what’s needed for pain relief, BU08028 did not slow breathing or cause other cardiovascular problems that lead to overdose deaths.
As for dependency, the National Institute on Drug Abuse reported that the monkeys “found it less rewarding than cocaine and two different opioids.”
BU08028 works by interacting with both opioid and non-opioid receptors in the brain.
Approximately 100 million Americans suffer from chronic pain, the NIH reports. That’s nearly a third of our population, and it has led to a national opioid crisis. Beyond addiction itself, the sharing of needles by addicts who progress to injecting has caused HIV and Hepatitis C rates to spike nationwide in communities that previously enjoyed low incidence of both diseases.
“A potent opioid analgesic without addictive and respiratory adverse effects has been a predominant goal for opioid national chemistry since the isolation of morphine from opium in the 19th century,” reads the PNAS abstract. “By examining behavioral, physiological, and pharmacologic factors, the present study demonstrates that BU08028 exhibits full antinociception and antihypersensitivity (pain relief) without reinforcing effects (i.e. abuse liability) respiratory depression, pruritus (itching), adverse cardiovascular effects, or acute physical dependence.”
Don’t expect a pharmaceutical company to begin churning out BU8028 for humans anytime soon. The next step would be a phase 1 trial on humans, followed by additional clinical trials. Clinical trials take years and are wildly expensive, but a non-addictive pain reliever in the face of a national opioid epidemic could result in political pressure and a slightly expedited process.
Even under the most hopeful scenarios, such a pharmaceutical opioid alternative would be several years away.