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researchers find a potential new way to make opioid use safer
researchers out of the university of arizona may have found a new way to improve opioid potency while minimizing its harmful effects, such as addiction and dependence.
opioid use can lead to significant harm, including death, but new research on a specific protein may have found a solution to the risks.
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opioids, the primary medication for acute and chronic pain conditions, are highly effective at treating pain but come with many potential side effects and adverse consequences, primarily due to the risk of dose tolerance. roughly 12.7 per cent of canadians use opioids as a form of pain relief.
when the body becomes used to the drug, it requires more for the same effects, leading to an increase in use, dependency or addiction, and in the worst cases, death from accidental overdose.
medical researchers from the university of arizona may have found a new way to make opioids safer by increasing their efficacy against pain while hindering the development of potentially harmful side effects.
opioids and their harms
one of the most significant harms associated with opioid use is death. many people who develop dose tolerance to opioids are given the go-ahead to take more to ease their pain. in some cases, when taken in high amounts, opioids can cause respiratory depression, which is what drives the high numbers of opioid-related deaths in the country.
between 2016 and 2023, canada saw 44,592 accidental opioid toxicity deaths.
the deaths can be attributed to several reasons, but many were caused by non-pharmaceutical use of the drug—which is another notable harm associated with the use of opioids. because of their addictive nature, people using opioids often develop a dependency on the drug.
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when they can no longer access it through medical providers or go through their prescriptions too quickly because they have to use more to get the same result, they may turn to street providers of opioids, which are significantly more dangerous.
these versions are not regulated and often contain other harmful substances, such as fentanyl, which can increase the risk of death substantially. according to statistics canada, roughly 9.7 per cent of people who were given opioids for pain ended up using them problematically or developing an addiction to the substance.
there are also side effects associated with opioids, although they are not as harmful as addiction and accidental overdoses. they can include:
- gastrointestinal issues, such as nausea, vomiting, constipation, and delayed gastric emptying
- dizziness or drowsiness because of their sedative effects
- increased sensitivity to pain
- immune and hormonal dysfunction
- muscle rigidity or involuntary muscle jerks
- an irregular heartbeat
- itchy skin
- dry mouth
the latest research aims to not only address the fatality and addiction risk of opioids but also the unwanted side effects.
the research
the study, published in the journal scientific reports, aimed to find a way to improve how people respond to opioids and hinder adverse events and side effects by investigating the role of heat shock protein 90 (hsp90). this protein helps other proteins in the body stabilize and stay protected against heat stress. it also works in cell signalling, cell transport, and the degradation of other proteins.
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researchers believe that this specific protein plays a role in how opioid receptors in the brain and spinal cord are activated and the ensuing pain relief that develops once the drugs activate these receptors.
researchers have been working on the connection between the hsp90 and the way both the brain and spinal cord register opioids as they enter the body. in the brain, the study found that reducing the amount of hsp90 led to a block in the pain-relieving properties of morphine, leading to opioids becoming ineffective.
however, when hsp90 is reduced in the spinal cord, the opposite becomes true, and the pain-relieving effects of morphine are amplified by two to four times. the level of opioid tolerance was also reduced when hsp90 was inhibited in the spinal cord, leading to the assumption that hsp90 can improve the potency of opioids while minimizing the chances of someone becoming tolerant to its effects.
addressing issues with hsp90 to help with opioid adverse events
in earlier studies on hsp90 inhibitors, it was found that when they’re nonselective, they can cause serious side effects, including macular degeneration. however, when the researchers were able to target individual isoforms of hsp90 or different variants of hsp90, each of which is similar but with slight differences, those risks were void.
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by isolating the isoforms of hsp90 in the spinal cord from those in the brain, the researchers were able to reduce the risks of side effects associated with using hsp90 inhibitors while maintaining the benefits as they pertain to opioid use.
future directions
the results from the study suggest that a new route of dose reduction can take place when given the right hsp90 inhibitor in people who use opioids. it’s thought that this can lead to a decrease in opioid deaths, dependency, and addiction, along with the mild or moderate side effects experienced by those who take the drugs for pain conditions.
the goal of the researchers is to create a pill using hsp90 inhibitors that people can use as a combinational therapy alongside opioids, making them safe for those who have to take them.
as of writing, the researchers are continuing to build on the results so that new options for those who need opioids can be available in the near future, leading to safer use, fewer deaths and addiction, and less pain for those living with chronic pain conditions.
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