A new non-narcotic, non-inflammatory method to treat pain

A lot of people go to their doctors because of chronic pain. Including pain from work injures, sports injuries, accidents, pain from tumors, post surgical pain, pain from medical conditions and other causes. Unfortunately, there are a limited number of ways to treat pain without medication. They include heat, rest, cold, or even mild exercise.

For more severe pain, medications might be needed. These can range from the fairly innocuous, like aspirin and ibuprofen, to quite strong opiates. And while many people think of drugs as a cure-all, there is always a risk of allergic reactions and side effects. Just as problematic, depending on the severity of the pain, sometimes drugs, even in combination, cannot produce complete relief. Sometimes neurosurgical procedures may help. Or topical or implantable devices. But sometimes they don’t.

Promising research in rats has shown that the activity of an enzyme that is already present in the body may have a strong effect on moderating pain. Researchers have discovered that aldehydes, naturally occurring molecules in the body, can cause pain. There is an enzyme that degrades aldehydes to compounds that do not produce pain.

Pain, via Shutterstock

Pain, via Shutterstock

Mice that have a genetically weakened form of this enzyme are more sensitive to pain. They show pain responses with even the mildest of pain-producing stimuli, while mice with normal enzymes don’t perceive pain at these levels.

Scientists used a drug (ALD1) to stimulate this aldehyde-degrading enzyme (aldehyde dehydrogenase-2 [ALDH2]). When they did, the mice that previously displayed pain with the most minimal stimulus, were much more resistant to the stimulus (showed less or no pain.)

The drug that stimulates the enzyme worked well both when given before the painful stimulus was given (to prevent pain) and after the painful stimulus was given (to relieve pain.) So this can have a twofold effect-prevent pain and also relieve it. This could have positive effects in anesthesiology, pain management and many other areas of medicine.

There are a number of Asian peoples who seem to have a lower pain tolerance that may be related to having a lower level of activity of the ALDH enzyme. It’s suspected that there may be about 500 million patients in this geographical area that have increased pain sensitivity. If this research is successful in humans it may be a tremendous help to this population.

Of course, it very well could work in the rest of us, as well. A drug that can decrease pain, that doesn’t have the side effects of opiates: drowsiness, constipation, cardiovascular and respiratory depression, etc. One that has no addiction potential and wouldn’t be sought-after as a drug of abuse on the streets.

It sounds wonderful. But we’ll have to wait for some human studies to see if it works this well in humans.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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11 Responses to “A new non-narcotic, non-inflammatory method to treat pain”

  1. UncleBucky says:

    I shared your post with a friend of mine who suffers from depression, and gets bouts of dread and anxiety far greater than what should be appropriate for meetings, negative social encounters, and schedule demands. This is fear, dread and anxiety attacks that bring her (in spite of meds and counseling) to the edge.

    I used your explanation, first reading it out in full, and then modified it in my explanation that perhaps this inappropriate fear, dread and anxiety are a remnant or the remains of a fight/flight “pain” that was constructed but persisted as a response to fight/flight, but is like a knot or scar tissue. In the absence of a real threat, and the presence of a routine meeting, scheduling conflict or social slight, her system go immediately to that remnant/memory and it becomes “alive” and real as it was previously. I never stated that it was a false response, or that it wasn’t really there, but rather a cross-wiring leads to that severe response instead of to a healthy response to a routine daily demand.

    She agreed, and thought that your post was a good way to think of the stuff that she suffers before a demanding situation. Especially the idea of it being self-sustaining in the absence of a truly bad threat.

    I’m not a…. I only play one on TV.


  2. Drew2u says:

    Hey Dr. Thoma, what do you think about this article suggesting that either HIV or Anti-HIV drugs are protecting people against Multiple Sclerosis? And, were the drugs the case – I don’t see where the article states which drugs are being used – then would there be any overlap with, say, Truvada or other PrEP drugs?


  3. Bodhi says:

    Exactly so

  4. 1jetpackangel says:

    Hopefully it’ll get us closer to the day when Mom doesn’t get pale and tight-lipped unless she gets the comfy chair because of her fibromyalgia. I don’t envy her weather-wise aches, either: when the barometer falls I feel like I have a tiny creature under my kneecap gnawing on the long nerve that goes down my shin, and it has really sharp teeth, too. She gets it… everywhere.

  5. Mike_in_the_Tundra says:

    I don’t think so. My daughter (adopted of course) has that alcohol intolerance thing, but she can pop out a baby without blinking an eye. If it was me, I think I would need to be sedated during the second month of pregnancy until it was over.

  6. nicho says:

    So, I guess I’ll have to stick with medical marijuana until they do the human trials. Pass the brownies, please.

  7. Baal says:

    I have done research in this area off and on since the 1970s, and I hate to rain on the parade. The big limitation is that the pain models used in these studies are not really models of chronic pain, they are models of pain evoked by ongoing inflammation associated with tissue damage, which can be quite sustained — think certain kinds of cancer pain, arthritis, the initial stages of back when a herniated disk is still inflamed, things like that. I think this is pretty interesting result and it may yield some novel therapeutic modalities, so that is very good. On the other hand, in chronic pain syndromes in a lot of patients there is no longer any tissue damage. For example, a patient suffers from a back injury, recovers fully, there is no discernible soft tissue reason why the pain should continue, and yet the patient is still debilitated. Think also phantom limb pain. These are neurological issues, not a peripheral issue, not understood, and somehow we have to find a way to change the way those circuits are signaling inappropriately. In other words, pain is something that is constructed by the nervous system. It is initiated by signals released from damaged tissues, but it can become self-sustaining in the absence of that damage.

  8. Bodhi says:

    Incredibly good news for those of us who have struggled with chronic pain for years.

  9. hydroursus says:

    OOOooooo could it be… that maybe the Asians that have low activity to ALDH enzyme also have low tolerance to alcohol? (connections???)

  10. Mike_in_the_Tundra says:

    I’ve been treated for chronic pain for at least 13 years. I have steroid epidurals (which of course is a medication, but not introduced throughout the body). Even more effective is my neural stimulator which is implanted in my back. I’m on my second one. The first was implanted in 2005, but was replaced with a more effective model.

  11. Bookbinder says:

    OMG! Soon please, really soon.

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