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Novel paths to pain management: older drugs doing new tricks!

If you follow the world of pain management as I do, you are always looking for new material...




For instance, recently the DEA tightened restrictions on some of the drugs already in the pain management arena.  Hydrocodone (a component of Vicodin® and the new long-acting product Zohydro®) and many other products is now a Schedule II drug.  That makes for a lot of  new restrictions/problems for those who use these products in their pain management regimen. Tramadol, which previously was not a scheduled drug , was recently placed in Schedule IV. This means that all products that contain tramadol are more tightly regulated than they used to be.


Now for some good news..

With this tightening of regulation...regarding all opioid drugs, and more recently the addition of the two above...there is research going on to find pain management applications for drugs currently in the marketplace that possess no abuse potential.  The tricyclic antidepressants and SSRI/SNRI drugs, for example, have found a meaningful place in neuropathic and chronic pain syndromes over the years. Similarly,some of the anticonvulsant medications have become routinely used this way as well.

In recent years, studies have been conducted using the angiotensin II antihypertensive drugs in the realm of pain management.  As early as 2002, an Italian study found that drugs in this group possessed the ability to alter pain perception in subjects who were taking these medications for high blood pressure. In 2013, a University of Kansas study showed similar results.

As we continue to live in a world where opioids provide ample pain management paired with high potential for abuse, abundant legislation and restrictions...it's obvious that looking elsewhere for answers will become more and more prevalent.  The jury is still out as to where the future lies...

Sources: NIH, KUMC.edu, Wikimedia

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