USA Today just published an article about Connecticut’s biotech company Cara Therapeutics and its efforts to make a non-addictive opioid. Cara was established in 2004 and is currently in the human testing trial of this new drug, the non-sexily named CR845, which received positive results in late October. Still, this isn’t the world’s first attempt at a non-addictive opioid: Sterling Drug Company released a similar drug called pentazocine in 1967 but it was unreliable at best and caused hallucinations at worst.
The pharmaceutical companies that manufacture painkillers like Oxycontin and Vicodin make billions of dollars a year so of course there are scientists trying to knock them down with their own billion-dollar alternative. Fifty three percent of drug overdoses in 2012 were from opioids and the number is rising sharply. Even as lawmakers attempt to stop this, cheap alternatives like heroin pop in its place. Cara is determined to put an end to this and is receiving a great deal of publicity and anticipation from Wall Street. Even Bob Twillman, the deputy executive director of policy for the American Academy of Pain Management, has called CR845 a “game changer” and said he can envision it being commonly prescribed in place of oxycodone.
Avoiding Those Pesky Brain Receptors
Unlike other painkillers, CR845 doesn’t enter the brain like opiates do. According to a piece in Forbes, Cara’s plan is to create a drug that works on opioid receptors in the body that don’t cause addiction. Creating a drug that numbs pain through the body’s—and not the brain’s—receptors is the goal here.
CR845 doesn’t have the classic side effects of other opioids (ie, nausea or depression), which leads me to believe the commercials for it might only be five seconds long since there won’t be a British lady listing a million awful potential side effects while we see a guy eating an early breakfast with his wife because he wasn’t out destroying his life.
Cara is going all out for the CR845 coming out party in the near future by first releasing oral and IV versions. The plan is for the IV version to be submitted to the American FDA in 2016 and the oral tablet in 2017. Cara expects the moneymaker rock star of the group—the pill—to be submitted shortly after those sneak previews, in 2018.
Of Course We All Have Our Critics
Rest assured that Cara is not without its critics. In Kentucky, there are more than 1,000 drug overdoses a year—a number that spiked when Oxycontin came on the scene in the early 2000s. Van Ingram, executive director of the Kentucky Office of Drug Control Policy, says his state hasn’t had the best luck with opioids and that he’s “skeptical” of CR845, no doubt remembering the time when slick pharmaceutical salesmen told hospitals that Oxycontin “wasn’t that addictive.” (In a Virginia criminal case from 2007, Oxy’s parent company Purdue Pharma actually had three executives plead guilty to misleading doctors, regulators and patients about their drug’s addictive qualities.)
USA Today talked to James Patrick Murphy, a pain specialist in Indiana, who says that “it’s difficult to get excited [because]there’s no silver bullet to treating chronic pain.” Of the 22,000 Americans who died of prescription drug overdoses in 2012, more than 16,000 were from opioids so it’s of course understandable why people are afraid of getting their hopes up for a drug company from the same small state as Oxycontin.
Whether or not people are wary of CR845, it’s coming soon. It may be a messy drug that makes teenagers trip or it could be rehab in a bottle, but a non-addictive opioid is possible now. CR845 could be the beginning of pain relief without the side effect of potentially killing a chunk of its users.
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