By Jonathan Springston, Editor, Relias Media

Scientists from Temple University and Genentech, Inc. may have unlocked a new chronic pain relief technique that could serve as a safer alternative to opioids.

Investigators focused their attention on an ion channel called transient receptor potential ankyrin 1 (TRPA1), a conduit that carries electrical signals telling the central nervous system to sense pain. Using synthesized molecules that target TRPA1, researchers created molecular simulations to generate structural models, hypothesized about changes to these molecules that would increase their efficacy, and proposed a theoretical model for how they act.

“To address chronic pain, we need to develop molecules that can offer relief to patients without the nasty side effects known to occur with opioids,” Vincenzo Carnevale, one of the study’s co-principal investigators, said in a statement. “Our goal is to inhibit pain signals in the nerve fibers where such signals originate — in your finger if you touch something hot, for instance — rather than treating it downstream in the central nervous system.”

In vitro testing validated the hypotheses generated during molecular simulations, and proof-of-concept testing in laboratory animals may start early next year. The authors acknowledged much work lies ahead.

“Although ion channels have been regarded as promising drug targets, significant challenges remain due to limitations in screening technologies, complex and poorly understood ligand-channel interactions, and, most often, the paucities of desirable chemical moieties,” Carnevale and colleagues wrote. “Our results demonstrate that the combination of experimental study and atomistic modeling may represent a crucial frontier in drug discovery efforts targeting TRPA1 and other ion channels.”

Certainly, the saga of opioid abuse is well documented, yet healthcare providers still are turning to pharmacologic solutions for chronic pain management. For example, the results of a recently published study revealed how physicians are treating chronic musculoskeletal pain, a frequent reason for medical visits. Using data collected between 2007 and 2015, the authors found physicians used pharmacologic approaches in more than 60% of visits. Opioids (21.5% of visits) were prescribed at more than double the rate of physical therapy.

The opioid crisis continues creating more liability risks for healthcare providers, who must contend with intense scrutiny regarding prescribing and management practices. A review of closed claims indicates hospitals and physicians can improve the way they follow guidelines and processes designed to reduce the risk, as reported in the February issue of Healthcare Risk Management.

Understanding when and why providers under- or overprescribe opioids may help standardize prescribing practices. However, many healthcare systems lack the tools to collect these data easily and meaningfully. The February issue of ED Management includes a detailed report about an electronic prescription accountability program created by the University of California, Irvine Medical Center. This program provides a robust picture of provider prescribing compared to traditional tracking methods. The approach includes peer-to-peer comparisons of prescribing practices and gives department leaders a helpful tool they can use to drive quality improvement.

Leaders stress the program is not meant to be punitive but rather is used to identify problem areas and provide education for improvement. Learn much more about the program and how you can develop a similar approach for your institution by clicking here.

For more on this and other neurology and complementary medicine research, please read future issues of Neurology Alert and Integrative Medicine Alert