July 30th, 2016

Opioids Can Make It Worse

This isn't a new idea, but I'm starting to see coverage of it in new areas.


Secondary coverage of this:


This is interesting, because the secondary coverage in this case is written by one of the (many) study authors. Some of the other study authors -- ones who probably did more of the actual research work, given that their names occur later in the list and Cynicism -- produced this:


Basically, if you take opioids for some kinds of pain which involve glial cells Acting Up and Making Things Hurt That Would Normally Not Hurt, the pain will continue much longer -- even after you quit taking the opioids. Yikes! I knew about opioid induced hyperalgesia, and that was heartbreaking to learn about (truly, a Fate Worse Than Death --- you take something thinking the worst it will do is kill you, but you hurt so bad you can't stand it, and it instead makes the pain worse). Now it turns out that you can't even narcan your way out of this Fate Worse Than Death.

Good news:

"the U.S. Food and Drug Administration (FDA) has now approved two glia-targeting drugs for Phase 2 clinical trials for the treatment of neuropathic pain: ibudilast (Avigen’s AV411) and propentofylline (Solace’s SLC022). In addition, ibudilast has FDA approval for testing its ability to increase the clinical efficacy of opioids. While having distinct mechanisms of action58,59, both ibudilast and propentofylline are orally available, blood-brain barrier permeable, glial activation inhibitors (based on microglial and astrocyte activation marker suppression) that have strong support treating pain from various rodent models58,59. Ibudilast has a long history of safety in humans for the treatment of asthma and post-stroke dizziness. Propentofylline has previously been tested in humans as far as Phase 3 trials for treating Alzheimer’s disease, with the trial discontinued for lack of efficacy."

ETA: Yeah, I just noticed that too. You CAN narcan your way out of this Fate.