Developing non-opioid therapeutics to alleviate pain among persons with opioid use disorder: a review of the human evidence

Oliveira, Debora; Fontenele, Rodrigo; Weleff, Jeremy; Sofuoglu, Mehmet; De Aquino, Joao P.

doi:10.1080/09540261.2023.2229430

Cited by 4 publications

(1 citation statement)

References 144 publications

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“…5,6 Despite the magnitude of this problem, there is a scarcity of controlled studies investigating pain management alternatives for those with OUD. 7 The three medications currently approved for OUD all exert their therapeutic benefits primarily through the mu-opioid receptor (MOR) and, given their various adverse effects, ranging from gastrointestinal and immune (e.g., methadone and buprenorphine) to hepatic (e.g., extended-release intramuscular naltrexone), there exists a great need for medications that work outside of this system. 8 Collectively, the challenges posed by opioid analgesic tolerance 9 and the escalation of the opioid epidemic, due to the widespread availability of fentanyl derivatives, further emphasize the urgency to explore novel, non-opioid therapeutics for pain and OUD.…”

Section: Introductionmentioning

confidence: 99%

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

Weleff,

Nunes,

Costa

et al. 2023

Preprint

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The rise of psychedelics in contemporary medicine has sparked interest in their potential therapeutic applications. While traditionally associated with countercultural movements and recreational use, recent research has shed light on the potential benefits of psychedelics in various mental health conditions. In this review, we explore the emerging role of psychedelics in the management of chronic pain and opioid use disorder (OUD), two critical areas in need of innovative treatment options. Pain control remains a significant clinical challenge, particularly for individuals with OUD and those who receive long-term opioid therapy (LTOT) who develop marked tolerance to opioid-induced analgesia. Despite the magnitude of this problem, there is a scarcity of controlled studies investigating pain management alternatives for these populations. Drawing from preclinical and human evidence, we highlight the potential of psychedelics to act on shared neurobiological substrates of chronic pain and opioid use disorder, potentially reversing pain- and opioid-induced neuroadaptations, such as central sensitization. We elaborate on the multifaceted dimensions of the pain experience (sensory, affective, and cognitive) and their intersections that overlap with opioid-related phenomena (opioid craving and withdrawal), hypothesizing how these processes can be modulated by psychedelics. After summarizing the available clinical research, we propose mechanistic insights and methodological considerations for the design of future translational studies and clinical trials, building on a shared clinical and neurobiological understanding of chronic pain and OUD. Our intention is to provide timely perspectives that accelerate the development and exploration of novel therapeutics for chronic pain and OUD amidst the escalating opioid crisis.

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Section: Introductionmentioning

confidence: 99%

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

Weleff,

Nunes,

Costa

et al. 2023

Preprint

View full text Add to dashboard Cite

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From taboo to treatment: The emergence of psychedelics in the management of pain and opioid use disorder

Weleff,

Nunes,

Costa

et al. 2024

Brit J Clinical Pharma

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The rise of psychedelics in contemporary medicine has sparked interest in their potential therapeutic applications. While traditionally associated with countercultural movements and recreational use, recent research has shed light on the potential benefits of psychedelics in various mental health conditions. In this review, we explore the possible role of psychedelics in the management of chronic pain and opioid use disorder (OUD), 2 critical areas in need of innovative treatment options. Pain control remains a significant clinical challenge, particularly for individuals with OUD and those who receive long‐term opioid therapy who develop marked tolerance to opioid‐induced analgesia. Despite the magnitude of this problem, there is a scarcity of controlled studies investigating pain management alternatives for these populations. Drawing from preclinical and human evidence, we highlight the potential of psychedelics to act on shared neurobiological substrates of chronic pain and OUD, potentially reversing pain‐ and opioid‐induced neuroadaptations, such as central sensitization. We elaborate on the multifaceted dimensions of the pain experience (sensory, affective and cognitive) and their intersections that overlap with opioid‐related phenomena (opioid craving and withdrawal), hypothesizing how these processes can be modulated by psychedelics. After summarizing the available clinical research, we propose mechanistic insights and methodological considerations for the design of future translational studies and clinical trials, building on a shared clinical and neurobiological understanding of chronic pain and OUD. Our intention is to provide timely perspectives that accelerate the development and exploration of novel therapeutics for chronic pain and OUD amidst the escalating opioid crisis.

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Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic

De Aquino,

Sloan,

Nunes

et al. 2024

AJP

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Developing non-opioid therapeutics to alleviate pain among persons with opioid use disorder: a review of the human evidence

Cited by 4 publications

References 144 publications

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

From taboo to treatment: The emergence of psychedelics in the management of pain and opioid use disorder

Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic

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