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End the struggle: pathways to HEAL the opioid crisis

“We all have the ability of making a decision and carrying it through,” director of the National Institute on Drug Abuse Dr Nora Volkow stated at the DIA 2018 Global Annual Meeting in Boston in June while discussing the Helping to End Addiction Long Term (HEAL) Initiative. However, she noted that opioids can affect this ability.  To assist opioid addicts with their struggle, doctors need innovative treatments.

While presenting at the plenary session and keynote address, Dr Volkow addressed the filled auditorium on the need to develop alternate and safer opioid analgesics that will improve quality of life for opioid users. For example, the generic drug buprenorphine is a partial opioid agonist, which is less likely than a full agonist to produce cravings and other withdrawal symptoms. It is important to note that there is a high degree of variability between patients, hence a need for development of new alternate therapies.

Lead Sheet, part of PharmSource, a GlobalData product, can be used to track the development of new classes of therapy; for example, ANS-6637 is a highly selective ALDH2 inhibitor being developed by Amygdala Neurosciences. The phase Ib drug candidate has shown reductions in opioid cravings and relapse in preclinical studies.

Routes of administration

Drugs that offer different route administration (ROA) such as sublingual formulations or extended release can also prevent abuse. Extended release naltrexone, a once-monthly medication used to prevent relapse, is an example. The patient does not need to remember to take the medicine daily and is non-addictive. Sublocade, a recently FDA-approved drug made by Indivior Group that can also be found using Lead Sheet, is an example of an extended release once-monthly subcutaneous injection of buprenorphine used to treat moderate to severe opioid use disorder. The buprenorphine releases gradually over a one-month period and blocks the addictive traits of opioids.

At DIA 2018, Dr Volkow emphasised the importance of understanding the brain and what drives addiction. Stimulation devices can target areas of the brain where there needs to be weakening or strengthening. The development of invasive and non-invasive devices could assist in mapping these areas, ultimately helping patients to gain control over their addiction as well as the treatment of pain.

Dr Volkow also discussed the HEAL Initiative. One of the goals of the initiative is to advance and accelerate new abuse- deterring treatments for pain from discovery to clinical development. Since there will always be a need for pain management treatment, it is crucial to develop safer alternatives for patients-options that are less likely to become addictive.

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