“America’s Long-Overdue Opioid Revolution Is Finally Here”

Smithsonian.com

When did our nation’s opioid crisis begin? Pretty much as soon as a German pharmacist isolated morphine from opium in 1805. Within the century, “addiction among soldiers was reportedly prevalent enough to earn the moniker, ‘the soldier’s disease,’ ” writes Jon Kelvey on Smithsonian.com.

But after more than 200 years of increased dependency and deaths, his article declares that “America’s Long-Overdue Opioid Revolution Is Finally Here.”

Here’s the tantalizing prospect of the piece: New compounds may provide patients with opioid-level pain relief without the awful side effects.

“If this research bears fruit,” Kelvey writes, “morphine may soon go the way of the 19th century bone saw.” Its replacements could include drugs “on which it is impossible to overdose” and “for which the risk of addiction will be negligible, or even disappear entirely.”

And that brings Kelvey to the topic of bunions. See, bunion surgery – while a fairly routine procedure – hurts like heck. So it was deemed a good way to try out oliceridine, an opioid compound from the pharmaceutical company Trevena. The drug was developed by pursuing neuroscience research pioneered by Laura Bohn, a professor at the Scripps Research Institute who studies opioid receptor signaling. (She has given morphine to a lot of mice.)

The trial involved 330 bunionectomy patients. After surgery, Kelvey notes, each was given four milligrams of morphine, oliceridine or a placebo. The placebo group didn’t feel any relief for hours. The morphine group reported improvements in about 30 minutes. The oliceridine group saw results in about two minutes.

In an abstract presented in October at the annual meeting of the American Society of Anesthesiologists, Trevena’s medical research team wrote that the drug could offer “rapid, effective analgesia with improved safety and tolerability.”

Sounds good, right? Kelvey notes that oliceridine is in Phase III clinical trials and is on track to hit the market within a few years. It could have some company: Other drugs in the works include UMB425, a synthetic opioid being developed by University of Maryland School of Pharmacy researcher Andrew Coop. It takes a different approach, but it’s also designed to beat morphine at pain relief and have fewer side effects.

Despite the promising findings, Kelvey wonders whether painkillers will always carry some risk of addiction. After all, Bayer started marketing a drug in the 1890s that was supposedly more potent and less addictive than morphine. It was called heroin.