Summary: Opioid addiction is a significant health threat. However, not all opioids are equally addictive. It means that making changes to the chemical structures of existing opioids may make them less addictive. Researchers think that they have found a way to do so. It appears that introducing the fluorine atom to various opioids may make them less addictive and yet ensure that they work well at the site of injury.

Opioid epidemics are showing no signs of receding. However, on the other side, we cannot negate that opioids are among the best painkillers. It means that giving up opioid use altogether may cause specific issues. Doctors may find it hard to manage moderate to severe pain without opioids. The Lives of those living with chronic pain may become miserable.

On the other hand, it has long been known that various opioids differ significantly, and some of them are not addictive at all. For example, codeine used to treat pain and dry cough has a low probability of causing addiction. Likewise, the anti-diarrheal drug loperamide does not cause addiction at all. Finally, even the synthetic opioid painkiller tramadol does not appear to cause addiction. Hence, why not try to create potent opioid painkillers that might lack any addictive effect?

There is a need to make some minor changes in the existing opioids so that they stop penetrating the blood-brain barrier and causing euphoria. This is possible, though challenging. However, considering the rise in opioid overdose and painkiller abuse, it is also a need of time. Moreover, opioids are almost irreplaceable in many clinical conditions.

Of course, chemists could have done it a long time back if it was that simple. Nonetheless, in recent years, there have been many technological advances. Thus, for example, computational chemistry has provided greater power to chemists.

Understanding Opioid Chemistry

Though there are many types of opioids, as one can see in the image above, they share some basic structures. However, though they have minor differences, they result in entirely different chemical and even biological properties.

Of course, one of the issues is that one cannot make significant structural changes to opioids, as it may result in reduced efficacy. However, suppose we want to reduce addictive effects of opioids. In that case, we need to find ways of making more significant changes to opioids and yet ensuring that their pain-killing effect is preserved.

This subject is not new. There are already some opioids that have a pretty different chemical structure when compared to morphine or other classical opioids. One such example is fentanyl.

Studies show that one of the ways in which opioids work is by becoming positively charged upon coming in contact with body fluids.

This positive charge helps opioids to bind on the target site. However, the problem with the existing opioids is that they become positively charged in all body fluids, in different organs, including the brain. So, it means that if we could find some way of preventing it or ensure that it only becomes charged at specific sites, this can help overcome addiction and many side effects of opioids.

Making Opioids Less Addictive

Researchers think it is necessary to change the opioid structure so that they become positively charged only in high-acidity environments. Studies show that injured tissues or inflammation sites have higher acidity than other body parts due to lactic acid accumulation. It means that any opioid requiring a greater acidic environment for activation will have a greater effect on the target site and will be less likely to cause euphoria.

Researchers have found this is possible, especially with the introduction of a fluorine (F) atom near the nitrogen, in the amine group of fentanyl. This will ensure that fentanyl remains less active in various body fluids but gains a higher activity level at the sites of inflammation and pain. What is exciting about this finding is that new studies show that introducing the fluorine molecule into morphine may also alter its characteristics. Thus, morphine will need a bit higher acidity to become active and start acting. This will help produce morphine that is more active in injured tissues, and thus less active in the brain and other sites, and hence less likely to cause addiction.

Now-a-days, the opioid treatment programs have started to utilize suboxone in their treatment, which is another potential medication. Researchers think they can explore an approach to alter the working of oxycodone and hydrocodone further. However, to date, this approach has only been tested in labs and appears to work. Thus, now there is a need to evaluate it in clinical trials.

Summary: Opioid overdose-related death is a significant problem in the US. Experts think identifying the population groups at a greater risk of opioid addiction may help counter this threat. Researchers at the University of Cincinnati analyzed the health data of Ohio state and found 12 population clusters where opioid addiction is more common. They found that white men aged 30-39 were more likely to abuse opioids, and black men aged 30-39 were at greater risk of death due to an overdose.

 

If we want to overcome opioid addiction, we need to identify the groups at risk and then work with them. For this, there are many tools, including the availability of big data. This is precisely what researchers at the University of Cincinnati did. They used data to understand who is at risk of opioid overdose in Ohio state. And they published the findings of their study in the journal Nature.

 

For the study, they analyzed the Ohio Health Department records between the years 2010 to 2017. They found that white men aged 30-39 were at high risk. Moreover, this population group was at considerable risk. The risk in men was several folds higher than in women. Similarly, they found that black men of the age were also at an elevated risk.

 

They also identified population clusters with a relatively higher risk of opioid addiction. They identified 12 hotspots in the state. These were mainly larger population groups or cities that were home to about 21% of the state’s population. These population clusters accounted for 40% of all opiate-related mortalities.

 

Researchers say that their findings are relevant in many ways. They can help guide policymakers. Not only that, but they also show the areas where agencies must focus on preventing opioid addiction. Using such data can help carry out focused efforts, like raising awareness of health hazards posed by opiate addiction, improving healthcare in those areas, and more.

 

As the researchers said that prevention is better than treatment. The primary purpose of the research is to find ways of reducing the risk of opioid addiction and overdose.

 

This data can also help scientists to understand what drives addiction in certain population groups. For example, earlier studies show that regular use of opiates reduces the production of intrinsic endorphins. Thus, a person starts feeling less excited about the daily activities and less satisfied from exercise, meeting friends, and other usual activities.
Since opiates desensitize the impact of natural endorphins, people addicted to these substances do not enjoy life as usual. Thus, they are more likely to seek pleasure in the substances. Finally, people become tolerant of opiates, and each time they need a higher dose to achieve similar results.

 

Researchers say that to counter this epidemic, health experts, educators, doctors, and public advocates, would need to come together and work.
They also noted other addiction patterns in the study, like those who had relatives addicted to opioids, were at a 10-time greater risk than others. However, researchers say there is still a need to better characterize those at a greater risk of opioid misuse.

 

Further, researchers noted that although it appears that legal opioid prescriptions contributed to this epidemic, there is more to the story. In recent years, law enforcement agencies have become stricter and even punished several doctors. However, these measures do not seem to help, as people turn to cheaper illicit drugs.

 

Suboxone is one of the drugs utilized to treat opioid addiction. However, the dose prescription must be kept under check.

 

Many of these illicit opiates, like heroin, are often laced with a cheaper and more potent synthetic drug called fentanyl. Fentanyl is a very potent drug. However, adding it to opiates significantly increases the risk of overdose. In addition, it appears that fentanyl is easier to synthesize or source.

 

This study has been limited to a single state. However, researchers think preparing such data for other states, or the whole nation would be even more helpful. Thus, in the near future, they want to conduct such a study for Kentucky and West Virginia.

 

Keeping all of the things in mind, it is better to opt for systematic, opioid addiction treatment programs.

Summary: Opioid epidemic has been ongoing for a long. However, the covid-19 pandemic has made the opioid crisis worse for many reasons. First, it appears that due to social isolation, reduced income, and other reasons, people are seeking relief from opioids. Additionally, the opioid crisis is also being made worse due to reduced attention and allocation of resources, as everyone is focusing more on countering covid-19. However, researchers warn that this would have long-term adverse consequences, causing a prolonged upsurge in opioid misuse or substance abuse disorder (SUD).

 

Opioid overdose is among the major causes of death among young adults and is a highly preventable condition. Even covid-19 epidemic would cause less mortality among healthy adults, which means that one can reduce the risk of contracting the infection through various interventions. However, those living with substance abuse disorder (SUD) are less likely to take these measures.

 

The opioid overdose epidemic has been ongoing in various parts of the US for a long time. However, in early 2020, another epidemic, or rather a pandemic, struck the world, causing millions of deaths. However, covid-19 is far from over. It is subdued but not conquered. It keeps coming back in waves as new strains keep emerging. Moreover, there is no vaccine that can protect people from covid-19 in all cases.

 

The problem is that people are more likely to see drugs during the pandemic and lockdowns. This is evident from the nationwide data. People feel more stressed and isolated, and thus they seek relief from drugs. Hence, looking for a timely opioid addiction treatment becomes a non-negotiable way out.

 

Although, covid-19 is not as significant a threat as it used to be due to mass vaccination. Nonetheless, it remains a significant public health threat. Moreover, current vaccines do not provide complete protection, and even worse, the immunity provided by these vaccines is waning in many, and they need a booster dose.

 

Opioids suppress the respiratory system, worsening covid-19 outcomes

 

Although most people may visualize opioid epidemics and covid-19 as separate disorders, that is not the case. Opioids suppress the respiratory system, harm pulmonary health, and covid-19 mainly causes lung infection.

 

Studies show that those living with SUD are at a 30% greater risk of hospitalization and are much more likely to diet due to severe covid-19 infection. In addition, many studies suggest that opioid use disorder increases the risk of contracting covid-19 by several times.

 

However, the problem is that covid-19 is only making the opioid epidemic worse. Data suggests that since the beginning of covid-19, opioid overdose-related deaths have increased in many parts of the nation.

 

Health experts worry that covid-19 pandemic is laying the grounds for the long-term resurgence of SUD. There are many reasons, including social isolation, increased mental stress, loss of employment, reduced income, and more. In addition, Covid-19 and opiate dependence is causing what researchers call “deaths of despair.”

 

Although we are confident that every covid-19 wave will weaken, this pandemic will end in the long run. However, even if this pandemic tsunami recedes, it is going to leave much damage behind, causing a resurgence in the opioid crisis.

 

These issues are not only due to stress or social isolation. Covid-19 has also disrupted SUD treatment and social support infrastructure, as everyone is focusing on controlling the more severe condition, covid-19. It means that many people living with SUD have discontinued their treatment, and now bringing them back to the clinics would require much effort.

 

Doctors say that people need to understand that the opposite of addiction is not sobriety. The opposite of addiction is connection. Unfortunately, healthcare workers and even family members have lost connection with those living with drug addiction.

 

Thus, the natural way to prevent further worsening of this condition is to start reconnecting with those living with opiate use disorder or SUD. Moreover, it is worth understanding that the opioid crisis may cause more mortalities in the long run than the current covid-19 wave. Of course, an adequate covid-19 response is essential, but it should not come at the expense of reduced attention to drug addiction.

 

Another less discussed reason for the opioid overdose epidemic is that covid-19 response has robbed healthcare workers of certain resources, as most of the sources are now being used to fight covid-19. Many of those affected by the opioid overdose epidemic see those poor policies as the significant causes driving the epidemic.

Summary: 

Opioid addiction has been raging for decades, causing more deaths than street drugs. Using pharmacological drugs to treat addiction to prescription drugs is a way but not the best method. Thus, many researchers are exploring safer treatments. CBD can help counter withdrawal syndrome, alter drug-seeking behavior, and help curb addiction. CBD’s safety is already proven, as it is one of the most commonly used health supplements. Thus, one pharma company is testing CBD to manage opioid addiction. Unlike CBD supplements, it contains a much higher CBD dosage, hence the need to test it extensively.

Opioid misuse epidemics have been raging for over three decades and have become a public health emergency. However, healthcare agencies have been too late to react to this epidemic. They only realized the severity of the issue when deaths caused by prescription drugs exceeded those caused by street drugs. Opioid misuse already causes three times more deaths than a heroin overdose. There are still twice more opioid abusers than those who use heroin.

Doctors have been treating drug addiction for decades. However, managing the addiction to prescription drugs is more challenging. After all, it means managing addiction to one prescription drug with another medication that is relatively safer but not entirely safe. In addition, medicines used to manage opioid addiction are not completely safe and have a range of side effects. Therefore, there is a need to find novel remedies that are safer for prolonged use.

CBD provides hope for managing opioid addiction

Opioid addiction is challenging to manage like any other drug addiction. It is about managing withdrawal syndrome and reducing drug-seeking behavior. For this, doctors use other drugs that help counter withdrawal symptoms and alter the drug-seeking habit. However, a drug used to manage these issues may also be addictive and are not essentially safe.

In recent years, CBD (cannabidiol) has been gaining significant popularity. It is among the most commonly used health supplements. It is safe for prolonged use and has many health benefits. For example, it may relieve pain, reduce stress and anxiety, help sleep better, and more.

CBD is one of the cannabinoids extracted from cannabis plants. However, it does not cause high or euphoria, which occurs due to a substance called THC. CBD products are THC-free or contain it only in traces. CBD is proven safe beyond doubt. Moreover, manufacturers extract CBD from hemp, not from marijuana. Hemp is also a variety of cannabis plants, but it is naturally low in THC and thus safe for regular human consumption.

This is not the first time researchers are testing CBD to manage health conditions. CBD is already approved to address some health conditions. Thus, there are already US FDA-approved CBD-based drugs. For example, a medication called Epidiolex is FDA approved to manage a rare kind of resistant epilepsy in children. Additionally, it appears that CBD is also suitable for conditions like multiple sclerosis and more.

Recently, researchers have started paying much attention to CBD as a remedy for drug addiction. Thus, a company called ANANDA Scientific Inc. has already filed an IND (new drug approval application) for the clinical trial of their unique CBD-based drug to manage opioid addiction. They have already begun the clinical trial, which is in the advanced stages. Moreover, there are significant chances of its approval as pilot studies have already shown the benefits of CBD in managing drug addiction.

Prescription-based CBD can work for managing addiction

Some people here may ask the question: why not simply use CBD-based health supplements that are readily available on the market? Well, CBD-based supplements would not work for many reasons. Firstly, the FDA does not test them. Thus, many of them may not contain much CBD. Many commonly sold health supplements contain hemp oil, which is a different thing and not a CBD product.

But perhaps the dosage is the more significant reason that usual CBD supplements would not work. This is because they contain tiny amounts of CBD. For example, the daily CBD dosage that one can get from usual health supplements is about 20-30 mg a day (usually a max of 70 mg). In contrast, US FDA-approved drugs may contain several hundred milligrams of CBD.

The company, ANANDA Scientific Inc.’s filing shows they are testing 600 to 1200 mg of CBD daily. That is several times higher dosage than one would find in a regular health supplement. That is why, a need for a clinical trial, and this explains why FDA regards it as a CBD-based drug and not a health supplement. Moreover, it is also expected to have better bioavailability and thus efficacy.

To sum up, we are pretty likely to see the introduction of safe, effective, CBD-based drugs to manage opioid addiction. This would be a high-dose CBD product and will be available on a doctor’s prescription.