The Potential Role of Dual Mechanistic Opioids in Combating Opioid Misuse
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OPIOID USE IN AN OPIOID EPIDEMIC (S DALAL, SECTION EDITOR)
The Potential Role of Dual Mechanistic Opioids in Combating Opioid Misuse Flaminia Coluzzi 1,2 & Sebastiano Mercadante 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose In the last years, the consumption of opioid analgesics in western countries, particularly in USA, has dramatically increased, and this rise has been paralleled by a proportional number of opioid-related deaths. To response to this health crisis, opioid guidelines have been developed to reduce the risk of harm related to opioid prescribing. Many activities have been suggested to face opioid epidemic. Clinicians should find a proper balance that meets the patient’s need for pain relief while minimizing abuse. The aim of this review was to examine the value of so-called dual opioids in this context Recent Findings Many activities have been suggested to face opioid epidemic. Clinicians should find a proper balance that meets the patient’s need for pain relief while minimizing abuse. Dual mechanistic opioids, including tramadol and tapentadol, could be less appealing for opioid abusers, because of the reduced mu-load. Significant differences have been observed in post-marketing surveillance between tramadol and tapentadol, in favor of the latter. Summary Further investigations are warranted for clarifying the role of innovative molecules for preventing opioid abuse. Keywords Opioids . Epidemics . Dual opioids . Abuse
Introduction Chronic pain is a disabling disease with a worldwide prevalence of about 30% [1, 2]. Pain control is a human right, and opioids are the most commonly prescribed drugs for severe chronic pain management. In the last decade in USA, there were increasing rates of opioid overdose and death. According to Center for Disease Control and Prevention (CDC) database, more than 750,000 people died from 1999 to 2018 for drug overdose, two-thirds of which involving opioids [3]. In 2018, opioid overdoses killed about 47,000 people in the USA (estimated US population in 2018: 327.2 million people) and This article is part of the Topical Collection on Opioid Use in an Opioid Epidemic * Sebastiano Mercadante [email protected]; [email protected] 1
Dept. Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
2
Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
3
Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via San Lorenzo Colli, 312/d, 90146 Palermo, Italy
4000 in Canada (estimated Canada’s population in 2018: 37.1 million people). This situation represents the most lifethreatening drug-related opioid epidemic the USA has never afforded [4]. The CDC has categorized the American opioid crisis in three waves. The first was in the 1990s, with a significant increase in opioid prescription drugs. In this wave, most of the deaths were related to both natural and semi-synthetic opioids (e.g., codeine, morphine, h
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