Chronic Pain and the Development of Pain
Relieving Medications
It takes a village
only after Research appreciates the villagers.
Chronic pain remains an unsolved public health problem. Millions of
Americans live with chronic pain, impacting many aspects of the lives of the
sufferers-and those who interact with the sufferers, whether they be family,
friends, or employers. In fact, chronic pain has a greater impact on the United
States economy in terms of health insurance, lost wages and reduced productivity than virtually any other chronic health condition, including
diabetes, hypertension, and heart disease.
There are several methodological issues that hinder the
development of novel pain-relieving medications. For example, over the last
couple of hundred years, most pain research has focused on more transient pain
models that do not result in tissue damage, and thus do not reflect what is
occurring in a chronic pain patient. On the other hand, studies focusing solely
on patients suffering from chronic pain may miss time points when an
intervention aimed at preventing chronic pain is most effective. Are there
missed opportunities whereby central sensitization can be interrupted,
effectively halting the metamorphosis of acute injury to chronic pain?
Scientists have sequenced the human genome, cloned all sorts of
organisms, and developed a variety of biological agents to treat heretofore
difficult to treat conditions. However, there have been few new drugs to treat pain over the last couple of
decades.
Therefore, many researchers are beginning to call for a shift in
the strategies utilized in the development of pain medications. It is important
to understand the changes in the nervous system that result in the pain experience,
and this encompasses the appreciation that acute and chronic pain are different
entities. Researchers must measure many signs and symptoms when studying pain,
not just whether a patient states their pain is a "2" or a
"10".
The principles of pharmacogenomics may assist researchers in
their quest for targeted pain relief. It might be possible to uncover a causal
relationship between genetic make-up and the response to medications.
It follows that the appropriate measures of patient response are
crucial in establishing a pattern of response, or lack therof. A focus on the
individual can thus lead to the identification of cohorts of pain sufferers
whose genetic pain mechanism "fits" a particular pharmacologic
intervention.
Answers to the conundrum of chronic pain, its relation to acute
pain, and the genetic and psychological composition of the individual, are
going to be found in the individual. This will go a long way to helping the
general population of chronic pain patients.
It takes a village only after Research appreciates the
villagers.
http://www.psychologytoday.com/blog/overcoming-pain/201107/chronic-pain-and-the-development-pain-relieving-medications
