HealthFirst-No more pain pills?

UNDATED (WJRT) -- (11/09/09) -- A new pain drug not only lasts longer, it comes without the risk of addiction.

HealthFirst reporter Leslie Toldo tells us about the new way to fight pain without one of the riskiest side effects.

This is in the works, under study right now. It's an injection that attacks chronic pain with longer-lasting effects.

For Meri Kennedy, cleaning isn't just tedious, it's painful.

Every ache is a reminder of a lifelong battle with chronic pain, the result of a long list of bad breaks. "Fractured ribs, polyps in my vocal chord, breast cancer, fractured hip, injury to my knee."

She relies on pain meds to get through the day. "I am afraid I can get addicted to the pain meds."

She may soon be able to stop the pill popping and get one injection that blocks pain for days.

"We have developed some liposomes, which, when injected either into the tissue or a nerve area, can numb the area for about a week," said Dr. Dan Kohane.

Liposomes (lie-puh-zomes) are specially-designed, fat-based particles that hold pain meds.

"When injected, liposomes just sit there and let the drugs leave," Kohane said.

The liposomes slowly release a potent anesthetic over time. In animal studies, the technique blocked nerves without damaging surrounding cells or muscles.

"The main advantages of this type of formulation over taking a narcotic, for example, to the best of our knowledge, these have no addictive potential but can treat the pain," Kohane said.

"I would welcome it, definitely," Kennedy said, enthusiastically.

One shot for days of relief. For chronic pain sufferers like Kennedy, it could turn the chores of daily life into much more pleasant experiences.

The anesthetic used in the study is a toxin naturally found in certain bacteria and pufferfish.

BACKGROUND: Pain control after surgery is a top priority of both doctors and patients. Methods of controlling post-surgical pain vary on a patient's needs and type of procedure, but all treatments administered in the hospital are relatively safe. Dangerous side effects are rare, but nausea, vomiting, itching and drowsiness are common, especially from opiod (narcotic) medications like morphine, fentanyl and hydromorphone.

OPIOID DEPENDENCE: Opioids like morphine, codeine and related drugs like oxycodone (OxyContin), hydrocodone (Vicodin) and meperidine (Demerol) are commonly prescribed to relieve chronic pain or pain following surgery, but they can cause drowsiness, and in higher doses, depressed respiration. Opioids can also cause euphoria in some patients and, if used long-term, tolerance. Tolerance means a person has to take higher and higher doses to achieve the same effects. Tolerance can eventually lead to physical dependence and addiction. According to the National Institute on Drug Abuse, those addicted to opioid medications are more likely to overdose, which can be fatal. Withdrawal symptoms of opioid addiction include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes and involuntary leg movements.

The Cleveland Clinic says the risk of developing an addiction to pain medication after surgery is very small, and that a bigger risk is posed by a prolonged recovery if pain medications are avoided. A panel of experts recently stated that opioids are actually a better choice than aspirin or ibuprofen for those 75 or older. A panel of experts concluded that the high doses of non-steroidal anti-inflammatory drugs (NSAIDS), which include aspirin and ibuprofen, necessary to control pain in some older patients are more dangerous than opioid medications. New pain management guidelines issued by the American Geriatric Society removed NSAIDS from the list of drugs recommended for frail elderly adults with persistent pain.

LONG-LASTING PAIN MANAGEMENT: Researchers at Children's Hospital Boston have developed an anesthetic drug delivery system that could make a huge impact on pain management and help patients avoid potentially addictive oral pain medications. They packaged the anesthetic saxitoxin in fat-based particles called liposomes. The result was a long-lasting, local anesthesia that had no apparent toxicity to nerve or muscles cells in rats. Previous attempts at similar drugs have not been successful because of the tendency of conventional anesthetics to damage surrounding tissue.

In the study, the best liposomes produced nerve blocks that lasted two days if they contained saxitoxin alone and seven days if combined with dexamethasone. Researchers are working to make the formulation last longer.

FOR MORE INFORMATION:

Jamie Newton
Public Relations
Children's Hospital Boston
(617) 919-3110

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