Opioid alternatives

This summer, my throat suddenly hurt. I hoped it was simply the result of exhaustion from being a bridesmaid at one too many weddings, but when it persisted for days, I decided to visit an urgent care clinic in Denver. As I sat in the waiting room, pondering whether the source was bacterial or viral, I noticed a sign hanging on the wall. It announced that the doctors at the clinic would not prescribe opioid pain medications due to problems with drug abuse. 

I wondered if this policy applied in Washington, DC, where my brother had recently shattered all three bones in his ankle in a climbing gym accident. What would his options be if he found himself in serious pain?

An issue bigger than opioid availability, though, was that my brother did not want to take addictive pain medication. He’s not alone — Wynn Legon, a neuroscientist at the Fralin Biomedical Research Institute at Virginia Tech Carilion, was offered a prescription for oxycodone to treat the lower back pain he developed as a cyclist. “I was like, ‘I’m not taking that,’” he said. “There's got to be a better way.”

Legon is among a group of researchers working to develop nonpharmacological pain management strategies by applying thermal, electrical, or mechanical stimuli to the brain or peripheral nervous system to change neural activity. Other scientists are looking to nature’s venomous predators for molecules that provide potent, nonaddictive forms of pain relief. 

As I helped produce stories on these alternative pain treatments for the November issue of DDN, I learned about how they could benefit my brother, Legon, and the millions of other people experiencing pain. While I had always associated pain with injury, surgery, and a handful of diseases, it is far more ubiquitous than that. Misshapen red blood cells can cause constant, throbbing pain, which is the number one reason people with sickle cell disease visit the hospital or emergency room. COVID-19 has emerged as another trigger for both acute and chronic pain. Whether severe or minor, short- or long-term, direct or indirect, almost everyone has a relationship with pain. 

These personal connections extend to all drug discovery research areas. In writing about them, I am not simply presenting cold, hard facts. Behind every study and every story are real people and their loved ones, all looking for a new life free from pain. Now that I’ve covered developments that could help one of my own family members, I’m striving to approach each project with the investment of someone personally affected. I hope that researchers and science journalists alike share this goal.

References

1. Centers for Disease Control and Prevention. Complications of sickle cell disease. At < https://www.cdc.gov/ncbddd/sicklecell/complications.html>.
2. Cascella, M. et al. COVID-pain: acute and late-onset painful clinical manifestations in COVID-19 – molecular mechanisms and research perspectives. J Pain Res  14, 2403-2412 (2021).