Lowering adrenaline as effective as opioids for severe/chronic pain

haidut

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Most of my readers know about the raging opioid abuse epidemic in Western countries. What most people do not know is that the bulk of the epidemic is not in usage of illegal opioids such as fentanyl, but in legally prescribed opioids such as methadone, oxycontin, and even morphine. There are thousands of medical outfits that specialize in cash-only "chronic pain treatments", which is simply a cover for prescribing a ton of opioids to patients willing to pay. The National Geographic even produced a documentary called "The Oxycontin Express", which detailed the epidemic of legal prescription opioid abuse in a network spanning 15+ US states. The excuse for over-prescribing opioids has always been that these patients are in severe chronic pain and nothing else works for improving their quality of life. The reality is that opioids abuse is driven by the de-industrialization of Western countries, and the hopelessness people feel as a result of them losing their opportunities for meaningful, creative work.

Now, political issues aside, medicine claims that it recognizes the moral hazards of opioids prescriptions, and Big Pharma has been avidly looking for chemicals that can replace opioids for chronic pain treatment. The study below demonstrates that treating chronic pain may be as simple as reducing excessive adrenaline output, by a mechanism of action through which the famous anti-stress drug clonidine exerts its beneficial effects. And since adrenaline is overproduced in stress, the study implicates stress in virtually any chronic/severe pain condition. That corroborates the "Rat Park" hypothesis/experiment that opioid "addiction" is nothing but a desperate attempt to medicate downstream effects of stress. Remove the stress, and the "addiction" (and in this case, chronic pain as well) disappears.

https://www.science.org/doi/10.1126/science.abn7065

"...New substances that activate adrenalin receptors instead of opioid receptors have a similar pain-relieving effect to opiates, but without the negative aspects such as respiratory depression and addiction. This is the result of research carried out by an international team of researchers led by the Chair of Pharmaceutical Chemistry at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)."

"...Peter Gmeiner is currently following a lead that seems very promising: “Many non-opioid receptors are involved in pain processing, but only a small number of these alternatives have as yet been validated for use in therapies”, he explains. Gmeiner and a team of researchers from Erlangen, China, Canada and the USA have now turned their attention to a new receptor that is responsible for binding adrenaline – the alpha 2A adrenergic receptor. There are already some analgesics that target this receptor such as brimonidine, clonidine and dexmedetomidine."
 
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Most of my readers know about the raging opioid abuse epidemic in Western countries. What most people do not know is that the bulk of the epidemic is not in usage of illegal opioids such as fentanyl, but in legally prescribed opioids such as methadone, oxycontin, and even morphine. There are thousands of medical outfits that specialize in cash-only "chronic pain treatments", which is simply a cover for prescribing a ton of opioids to patients willing to pay. The National Geographic even produced a documentary called "The Oxycontin Express", which detailed the epidemic of legal prescription opioid abuse in a network spanning 15+ US states. The excuse for over-prescribing opioids has always been that these patients are in severe chronic pain and nothing else works for improving their quality of life. The reality is that opioids abuse is driven by the de-industrialization of Western countries, and the hopelessness people feel as a result of them losing their opportunities for meaningful, creative work.

Now, political issues aside, medicine claims that it recognizes the moral hazards of opioids prescriptions, and Big Pharma has been avidly looking for chemicals that can replace opioids for chronic pain treatment. The study below demonstrates that treating chronic pain may be as simple as reducing excessive adrenaline output, by a mechanism of action through which the famous anti-stress drug clonidine exerts its beneficial effects. And since adrenaline is overproduced in stress, the study implicates stress in virtually any chronic/severe pain condition. That corroborates the "Rat Park" hypothesis/experiment that opioid "addiction" is nothing but a desperate attempt to medicate downstream effects of stress. Remove the stress, and the "addiction" (and in this case, chronic pain as well) disappears.

https://www.science.org/doi/10.1126/science.abn7065

"...New substances that activate adrenalin receptors instead of opioid receptors have a similar pain-relieving effect to opiates, but without the negative aspects such as respiratory depression and addiction. This is the result of research carried out by an international team of researchers led by the Chair of Pharmaceutical Chemistry at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)."

"...Peter Gmeiner is currently following a lead that seems very promising: “Many non-opioid receptors are involved in pain processing, but only a small number of these alternatives have as yet been validated for use in therapies”, he explains. Gmeiner and a team of researchers from Erlangen, China, Canada and the USA have now turned their attention to a new receptor that is responsible for binding adrenaline – the alpha 2A adrenergic receptor. There are already some analgesics that target this receptor such as brimonidine, clonidine and dexmedetomidine."
My husbands situation, last year, got exponentially worse, immediately, when he was prescribed pain medication.
 

aguilaroja

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The study below demonstrates that treating chronic pain may be as simple as reducing excessive adrenaline output, by a mechanism of action through which the famous anti-stress drug clonidine exerts its beneficial effects. And since adrenaline is overproduced in stress, the study implicates stress in virtually any chronic/severe pain condition. ...
https://www.science.org/doi/10.1126/science.abn7065
Yes, the commerce motivation for exploring pain relief through reducing adrenaline-type effects has been low.
Clonidine, the most available alpha-2 adrenergic agonist, has been generic for decades.
Of course, these pharma agents have various side effects, including possibly severe lowering of blood pressure and over-sedation.
Dexmedetomidine has been known as a substance, but has more recently been investigated more. Maybe some business is searching for a dexmedetomidine congener to market at high price.

Also, a couple of side notes:

(1) Alpha-2 adrenergic agonists inhibit lipolysis, so some anti-excitatory effect may include reduced mobilizations of FFA ("PUFA FFA").

(2) The "muscle relaxant: tizanidine (Zanaflex) is an also alpha-2 adrenergic agonist. So perhaps, in some cases, its pain relief action is lowering adrenaline stress effects rather than "antispasmodic" muscle "relaxing"

"...administration of α2 adrenoceptor agonists into the psoas major muscle relieves chronic inflammatory pain induced by CFA. Local injection of dexmedetomidine also exerted anti-inflammatory and anti-sympathetic effect by activating α2-adrenoceptor in the psoas major muscle."

"Preoperative administration of systemic alpha-2 agonists significantly reduced cumulative opioid consumption up to 6 h...after surgery. Moreover, preoperative administration of alpha-2 agonists significantly reduced postoperative pain intensity at 6 h...."

"Propofol and α2-agonists attenuate the formation of ROS during hypoxia and after reoxygenation. Furthermore, the α2-agonists treatment restored membrane potential to values comparable to the normoxic control and were both more effective than Propofol."

"Adjuvant medications like alpha 2 agonists may play a significant role in prolonging spinal blockade as well as limiting cardiovascular complications such as hypotension and bradycardia. The use of alpha 2 agonists instead of opioid medications intrathecally decreases pruritus and delayed respiratory depression."

"...[spared nerve injury] SNI-induced increase in plasma membrane RGS4 expression was associated with low efficacy of α2AR agonists in a model of persistent, chronic neuropathic pain."

 

aguilaroja

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Incidentally, the newer and trendy alpha-2 agonist, dexmedetomidine, reduced the iron dependent cell death (ferroptosis) in hemorraghic (bleeding) brain injury. I don't know where this represents a general protective effect including a specific protective effect. It is an interesting possibility.

"...administering DEX reduced the damage induced by ferroptosis after ICH by regulating iron metabolism, amino acid metabolism and lipid peroxidation processes."
 
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haidut

haidut

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Incidentally, the newer and trendy alpha-2 agonist, dexmedetomidine, reduced the iron dependent cell death (ferroptosis) in hemorraghic (bleeding) brain injury. I don't know where this represents a general protective effect including a specific protective effect. It is an interesting possibility.

"...administering DEX reduced the damage induced by ferroptosis after ICH by regulating iron metabolism, amino acid metabolism and lipid peroxidation processes."

Very interesting, thanks. It looks like it should be useful for preventing heart failure after a hemorrhaging heart attack.
 

Harley

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Can someone explain how these receptors work?

The original article says:
"New substances that activate adrenalin receptors instead of opioid receptors have a similar pain-relieving effect to opiates".

I say this because 'lowering adrenaline' sounds like the opposite to 'activating adrenaline receptors'.
 

Candeias

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Can someone explain how these receptors work?

The original article says:


I say this because 'lowering adrenaline' sounds like the opposite to 'activating adrenaline receptors'.

"Dexmedetomidine is a specific and selective alpha-2 adrenoceptor agonist. By binding to alpha-2 adrenergic presynaptics, it inhibits the release of norepinephrine and, therefore, stops the transmission of pain signals."
 
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