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Using Opioids for Pain Control Without Addiction

Addictive painkillers such as opioid analgesics remain in the center of an ongoing debate. Misuse and abuse of such medications has made it difficult for chronic pain patients who really need this management tool to obtain it.

Scientists are trying to develop an abuse-deterrent opioid product. Such a drug would provide the pain relief needed without causing addiction.

But there are many challenges facing this type of research. A two-day meeting to discuss opioid abuse resistance was held in 2005. This report is a summary of experts' opinion on this topic from those meetings.

Terms used to describe the problem of opioid-addiction such as misuse, abuse, dependence, tolerance, and addiction were defined. The types of opioid abusers and ways to abuse these drugs were also discussed.

For example, opioid use goes beyond pill popping. Some people crush the pills then snort, smoke, or inject the drug. This gives them a faster, more intense high.

The majority of opioid users have a lifetime history of addictions. It's estimated that only 30 per cent of opioid abusers have a medical need for pain control. Healthcare professionals such as doctors and nurses can also become addicted.

There are many factors to consider when developing an abuse-resistant drug that controls pain. Given the many and different ways people use and abuse drugs, it may not be possible to create one pill that meets all needs.

How can research be done when there are so many different types of people who may use a deterrent product? Can human studies be done without causing opioid abuse? What kind of labeling should go on the products? How will they be marketed and advertised? Will drug abusers be able to find ways to misuse an opioid-deterrent?

These and many other questions were posed and discussed by the experts at this symposium. It is agreed upon that a comprehensive approach is needed to prevent drug abuse. Opioid-deterrent drugs will eventually be a part of the management program. The authors conclude it will be necessary to find ways to set clear standards for the use of such products.

References: Nathaniel P. Katz, MD, MS, et al. Challenges in the Development of Prescription Opioid Abuse-deterrent Formulations. In Clinical Journal of Pain. October 2007. Vol. 23. No. 8. Pp. 648-660.

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