Failed arthritis drug may prevent opioid addiction

Used syringes are discarded at a needle exchange clinic where users can pick up new syringes and other clean items for those dependent on heroin. As prescription painkillers become increasingly expensive and regulated, more and more Americans are turning to heroin to fight pain or to get high. (Credit: Getty images)

A drug already proven safe for use in people may prevent opioid tolerance and physical dependence when used in combination with opioid-based pain medications, according to a new study in mice.

Researchers have discovered that a compound previously tested to treat osteoarthritis pain appears to block neuropathic pain and decrease signs of opioid dependence.

When drug manufacturer Eli Lilly and Co. conducted human trials of the drug to treat osteoarthritis pain, they found that the drug lacked efficacy. Researchers had not, however, tested the drug’s use in treating other kinds of pain and lessening opioid dependence.

“The potential to quickly begin using this compound in combination with opioid-based medication to treat pain and reduce addiction makes this discovery very significant,” says lead investigator Andrea G. Hohmann, a chair of neuroscience and professor in the Indiana University Bloomington psychological and brain sciences department. “We already know this drug is safe for use in people, so moving into human trials will not require as many regulatory hurdles.”

The need for non-addictive alternatives to opioid-based pain medication is urgent due to the rapid rise in overdose deaths over the past decade. According to the Centers for Disease Control and Prevention, over 64,000 Americans died from drug overdoses in 2016, including from illicit drugs and prescription opioids.

To test the potential of the experimental drug to treat pain and reduce addiction symptoms, the scientists administered the compound and the opioid morphine to male mice with neuropathic pain. While morphine initially reduced the pain, mice quickly developed tolerance to morphine’s effectiveness, similar to people who require higher doses of opioid over time to achieve relief.

When a low dose of the experimental drug was combined with morphine, however, the mice no longer became tolerant to morphine, and that lack of tolerance remained even after researchers discontinued the experimental drug. The researchers also found the experimental drug could produce sustained pain relief on its own at higher doses.

In another experiment, researchers gave mice either morphine alone or morphine in combination with the experimental drug, and then treated them with naloxone, which blocks the effect of opioids and induces opioid withdrawal symptoms. Remarkably, Hohmann says, the experimental drug also decreased the severity of these symptoms.

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Together, these results suggest the experimental drug could, in combination with opioids, prevent tolerance, allowing satisfactory pain treatment with fewer side effects, or wean opioid-tolerant individuals off these drugs.

The researchers chose to explore the failed osteoarthritis drug because they had previously found that the compound acted in a unique way upon a target in the body known to play a role in pain relief.

The researchers report their findings in the journal Molecular Pharmacology. The National Institute on Drug Abuse and National Cancer Institute contributed support for the work.

Source: Indiana University