Are there non-addictive pain medications that are as effective as opiates? The short answer to that question is no, not yet. Not in a general sense, anyhow. However, not everyone is the same and not everyone has the same kind of pain. For example, neuropathy, or nerve pain, may respond just as well, or even better, to non-opioid drugs such as pregabalin and gabapentin. While not opioids, both gabapentin and pregabalin still carry some risk of dependence, especially in those with a substance abuse history. Both are classified as C-V. This is the very lowest of the five groups of controlled drugs in the United States.
How Do Opioids Work?
To understand why opioids work so well for pain, you must first understand some basic information about brain structure. Humans, and most animals, have opioid receptors located throughout the body. There are these receptors in the stomach and intestines, for example. However, opioid receptors are most concentrated in the brain, especially in the parts known as the limbic system and brain stem. The limbic system is associated with mood and emotion. Many psychoactive drugs affect this part of the brain. The brain stem is primarily involved in basic life functions like breathing and heartbeat. That’s why an opioid overdose is so dangerous. If too many receptors are activated at the same time, a person can stop breathing and die.
The brain produces its own natural opioids. These are called endogenous opioids, meaning those produced from within the body. These natural endorphins attach to opioid receptors. It’s kind of like a key fitting into a lock. Only a certain kind of molecule can bind to and activate an opioid receptor. Endorphins boost mood and help to dull the pain that may come from everyday activities. They are also released during intense exercise. This is sometimes referred to as a runner’s high.
By design, the opium poppy produces substances, especially morphine and codeine, that can also bind to opioid receptors, producing profound analgesia, or pain relief. Feelings of relaxation and sedation are common, too. Some people, but not all, will also experience euphoria. This euphoric feeling reinforces the desire for more of that feeling, leading to dependence and addiction. It’s this activation of the brain’s opioid receptors that makes opioids so effective at relieving pain. So far, no known substance can produce this same kind and level of pain relief. Remember, only opioids can activate the receptor. Not all opioids come from the opium poppy, however. Some of them, like methadone and fentanyl, are totally synthetic.
The brain has three main types of opioid receptors. They are the mu, the delta and the kappa. It’s the mu receptor, or MOR, that is most responsible for the pain relief effect, along with sedation. Because it recruits, or attracts, a substance called beta-arrestin, the MOR is also associated with overdose death from the lack of oxygen when an overdose victim stops breathing.
A Novel Drug
There is a new substance, called AT-121, that may someday provide pain relief as effective as the opioids available today, but without the addiction potential and dangerous side effects. The drug is very powerful, but even in high doses it appears not to suppress the breathing reflex. AT-121 binds to and activates the MOR the same as any other opioid, but there is a critical difference. It also activates the NOP receptor, another kind of opioid receptor not associated with the standard opioids in use today, such as oxycodone and hydrocodone. It’s this activity at the NOP receptor that seems to prevent harmful opioid side effects.
AT-121 doesn’t appear to cause physical dependence or tolerance even after long-term use, either. It might even be useful for treating opioid addiction. AT-121 is still in its very early testing stages. It’s not possible to say if it will be a viable alternative to the standard opioids of today. It may prove to have serious side effects. It might prove to be addictive after all. There was a time in the past when heroin was thought to be a cure for morphine addiction. At the end of the day, even AT-121 tells us that truly effective and powerful pain relief will probably always involve the brain’s opioid receptor sites in some way.
If You Need Help
For now, opioids can cause addiction and dependence. If you are addicted to opioids, alcohol or any other substance, and you want help, we are here to serve you. Our number is 772-934-6580. Call anytime and let us work with you to help you find the help you need.