The Painkilling Power Of Opioids, Without The Harm?

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When it comes to painkilling medications, they can generally be categorized into two kinds:

  • non-opioids (e.g. ibuprofen, paracetamol/acetaminophen, aspirin)
  • ones that actually work for something more serious than a headache

That’s an oversimplification, but broadly speaking, when there is serious painkilling to be done, that’s when doctors consider it’s time to break out the opioids.

Nor are all opioids created equal—there’s a noteworthy difference between codeine and morphine, for instance—but the problems of opioids are typically the same (tolerance, addiction, and eventual likelihood of overdose when one tries to take enough to make it work after developing a tolerance), and it becomes simply a matter of degree.

See also: I’ve been given opioids after surgery to take at home. What do I need to know?

So, what’s the new development?

A team of researchers have found that the body can effectively produce its own targetted painkilling peptides, similar in function to benzodiazepines (an opioid drug), but—and which is a big difference—confined to the peripheral nervous system (PNS), meaning that it doesn’t enter the brain.

  • The peptides killing the pain before it can reach the brain is obviously good because that means the pain is simply not experienced
  • The peptides not having any effect on the brain, however, means that the mechanism of addiction of opioids simply does not apply here
  • The peptides not having any effect on the brain also means that the CNS can’t be “put to sleep” by these peptides in the same way it can if a high dose of opioids is taken (this is what typically causes death in opioid overdoses; the heart simply beats too slowly to maintain life)

The hope, therefore, is to now create medications that target the spinal ganglia that produce these peptides, to “switch them on” at will.

Obviously, this won’t happen overnight; there will need to be first a lot of research to find a drug that does that (likely this will involve a lot of trial and error and so many mice/rats), and then multiple rounds of testing to ascertain that the drug is safe and effective for humans, before it can then be rolled out commercially.

But, this is still a big breakthrough; there arguably hasn’t been a breakthrough this big in pain research since various opioid-related breakthroughs in the 70s and 80s.

You can see a pop-science article about it here:

Chronic pain, opioids and natural benzos: Researchers discover how body can make its own “sleeping pills”

And you can see the previous research (from earlier this year) that this is now building from, about the glial cells in the spinal ganglia, here:

Peripheral gating of mechanosensation by glial diazepam binding inhibitor

But wait, there’s more!

Remember what we said about affecting the PNS without affecting the CNS, to kill the pain without killing the brain?

More researchers are already approaching the same idea to deal with the same problem, but from the angle of gene therapy, and have already had some very promising results with mice:

Structure-guided design of a peripherally restricted chemogenetic system

…which you can read about in pop-science terms (with diagrams!) here:

New gene therapy could alleviate chronic pain, researchers find

While you’re waiting…

In the meantime, approaches that are already available include:

Take care!

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  • From Lupus To Arthritis: New Developments

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This week’s health news round-up highlights some things that are getting better, and some things that are getting worse, and how to be on the right side of both:

    New hope for lupus sufferers

    Lupus is currently treated mostly with lifelong medications to suppress the immune system, which is not only inconvenient, but also can leave people more open to infectious diseases. The latest development uses CAR T-cell technology (as has been used in cancer treatment for a while) to genetically modify cells to enable the body’s own immune system to behave properly:

    Read in full: Exciting new lupus treatment could end need for lifelong medication

    Related: How to Prevent (Or Reduce The Severity Of) Inflammatory Diseases

    It’s in the hips

    There are a lot of different kinds of hip replacements, and those with either delta ceramic or oxidised zirconium head with a highly cross-linked polyethylene liner/cup have the lowest risk of need for revision in the 15 years after surgery. This is important, because obviously, once it’s in there, you want it to be able to stay in there and not have to be touched again any time soon:

    Read in full: Study identifies hip implant materials with the lowest risk of needing revision

    Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad

    Sooner is better than later

    Often, people won’t know about an unwanted pregnancy in the first six weeks, but for those who are able to catch it early, Very Early Medical Abortion (VEMA) offers a safe an effective way of doing so, with success rate being linked to earliness of intervention:

    Read in full: Very early medication abortion is effective and safe, study finds

    Related: What Might A Second Trump Presidency Look Like for Health Care?

    Increased infectious disease risks from cattle farms

    Many serious-to-humans infectious diseases enter the human population via the animal food chain, and in this case, bird flu becoming more rampant amongst cows is starting to pose a clear threat to humans, so this is definitely something to be aware of:

    Read in full: Bird flu infects 1 in 14 dairy workers exposed; CDC urges better protections

    Related: With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu

    Herald of woe

    Gut health affects most of the rest of health, and there are a lot of links between gut and bone health. In this case, an association has been found between certain changes in the gut microbiome, and subsequent onset of rheumatoid arthritis:

    Read in full: Changes in gut microbiome could signal onset of rheumatoid arthritis

    Related: Stop Sabotaging Your Gut

    Take care!

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  • Neurologists Debunk 11 Brain Myths

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Neuroscientists Dr. Santoshi Billakota and Dr. Brad Kamitaki debunk 11 myths about the brain. How many did you know?

    From the top

    Without further ado, the myths are…

    1. “We only use 10% of our brains”: False! We use most parts of our brain at different times, depending on the activity. PET/MRI scans show widespread usage.
    2. “The bigger the brain, the smarter the creature”: False! While there’s often a correlation, intelligence depends on brain complexity and development of specific regions, not overall size. For this reason get, for example, some corvids that are more intelligent than some dogs.
    3. “IQ tests are an accurate measure of intelligence”: False! IQ tests measure limited aspects of intelligence and are influenced by external factors like test conditions and education.
    4. “Video games rot your brain”: False! Video games can improve problem-solving, strategy, and team-building skills when played in moderation.
    5. “Memory gets worse as you age”: Partly false. While episodic memory may decline, semantic and procedural memory often improve with age.
    6. “Left-brained people are logical, and right-brained people are creative”: False! Both hemispheres work together, and personality or skills are influenced by environment and experiences, not brain hemispheres.
    7. “You can’t prevent a stroke”: False! Strokes can often be prevented by managing risk factors like blood pressure, cholesterol, and lifestyle choices.
    8. “Eating fish makes you smarter”: False! Eating fish, especially those rich in omega-3s, can support brain health but won’t increase intelligence.
    9. “You can always trust your senses”: False! Senses can be deceptive and influenced by emotions, memories, or neurological conditions.
    10. “Different sexes have different brains”: False! Structurally, brains are the same regardless of chromosomal sex; differences arise from environmental (including hormonal) and experiential factors—and even there, there’s more than enough overlap that we are far from categorizable as sexually dimorphic.
    11. “If you have a seizure, you have epilepsy”: False! A seizure can occur from various causes, but epilepsy is defined by recurrent unprovoked seizures and requires specific diagnosis and treatment.

    For more on all of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    The Dopamine Myth ← a bonus 12th myth!

    Take care!

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  • Fast Burn – by Dr. Ian K. Smith

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Intermittent fasting seems simple enough: how complicated can “stop eating for a bit” be? Well, there are nuances and tweaks and hacks and “if you do this bit wrong it will sabotage your benefits” things to know about, too.

    Dr. Smith takes us through the basic essentials first, and covers each of the main kinds of intermittent fasting, for example:

    • Time-restricted eating; 12:12, 16:8, etc, with those being hours fasting vs hours eating
    • Caloric restriction models; for example 5:2, where one eats “normally” for 5 days a week, and on two non-consecutive days, eats only 500 calories
    • Day off models and more; for example, “no eating on Sundays” that can, depending on your schedule, be anything from a 24-hour fast to 36 hours or more.

    …and, most notably, what they each do metabolically.

    Then, the real meat of the book is his program. Taking into account the benefits of each form of fasting, he weaves together a 9-week program to first ease us gently into intermittent fasting, and then enjoy the maximum benefits with minimum self-sabotage.

    Which is the biggest stumbling-block for many trying intermittent fasting for the first time, so it’s a huge help that he takes care of this here.

    He also includes meal plans and recipes; readers can use those or not; the fasting plan stands on its own two feet without them too.

    Bottom line: if you’ve been thinking of trying intermittent fasting but have been put off by all the kinds or have had trouble sticking to it, this book may be just what you need.

    Click here to check out Fast Burn on Amazon and see what you can achieve!

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  • You can thaw and refreeze meat: five food safety myths busted

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This time of year, most fridges are stocked up with food and drinks to share with family and friends. Let’s not make ourselves and our guests sick by getting things wrong when preparing and serving food.

    As the weather warms up, so does the environment for micro-organisms in foods, potentially allowing them to multiply faster to hazardous levels. So put the drinks on ice and keep the fridge for the food.

    But what are some of those food safety myths we’ve long come to believe that aren’t actually true?

    Myth 1: if you’ve defrosted frozen meat or chicken you can’t refreeze it

    From a safety point of view, it is fine to refreeze defrosted meat or chicken or any frozen food as long as it was defrosted in a fridge running at 5°C or below. Some quality may be lost by defrosting then refreezing foods as the cells break down a little and the food can become slightly watery.

    Another option is to cook the defrosted food and then divide into small portions and refreeze once it has stopped steaming. Steam in a closed container leads to condensation, which can result in pools of water forming. This, combined with the nutrients in the food, creates the perfect environment for microbial growth. So it’s always best to wait about 30 minutes before refrigerating or freezing hot food.

    Plan ahead so food can be defrosted in the fridge, especially with large items such as a frozen turkey or roll of meat. If left on the bench, the external surface could be at room temperature and micro-organisms could be growing rapidly while the centre of the piece is still frozen!

    Myth 2: Wash meat before you prepare and/or cook it

    It is not a good idea to wash meats and poultry when preparing for cooking. Splashing water that might contain potentially hazardous bacteria around the kitchen can create more of a hazard if those bacteria are splashed onto ready-to-eat foods or food preparation surfaces.

    It is, however, a good idea to wash fruits and vegetables before preparing and serving, especially if they’re grown near or in the ground as they may carry some dirt and therefore micro-organisms.

    This applies particularly to foods that will be prepared and eaten without further cooking. Consuming foods raw that traditionally have been eaten cooked or otherwise processed to kill pathogenic micro-organisms (potentially deadly to humans) might increase the risk of food poisoning.

    Fruit, salad, vegetables and other ready-to-eat foods should be prepared separately, away from raw meat, chicken, seafood and other foods that need cooking.

    Myth 3: Hot food should be left out to cool completely before putting it in the fridge

    It’s not OK to leave perishable food out for an extended time or overnight before putting it in the fridge.

    Micro-organisms can grow rapidly in food at temperatures between 5° and 60°C. Temperature control is the simplest and most effective way of controlling the growth of bacteria. Perishable food should spend as little time as possible in the 5-60°C danger zone. If food is left in the danger zone, be aware it is potentially unsafe to eat.

    Hot leftovers, and any other leftovers for that matter, should go into the fridge once they have stopped steaming to reduce condensation, within about 30 minutes.

    Large portions of hot food will cool faster if broken down into smaller amounts in shallow containers. It is possible that hot food such as stews or soup left in a bulky container, say a two-litre mixing bowl (versus a shallow tray), in the fridge can take nearly 24 hours to cool to the safe zone of less than 5°C.

    Myth 4: If it smells OK, then it’s OK to eat

    This is definitely not always true. Spoilage bacteria, yeasts and moulds are the usual culprits for making food smell off or go slimy and these may not make you sick, although it is always advisable not to consume spoiled food.

    Pathogenic bacteria can grow in food and not cause any obvious changes to the food, so the best option is to inhibit pathogen growth by refrigerating foods.

    Myth 5: Oil preserves food so it can be left at room temperature

    Adding oil to foods will not necessarily kill bugs lurking in your food. The opposite is true for many products in oil if anaerobic micro-organisms, such as Clostridium botulinum (botulism), are present in the food. A lack of oxygen provides perfect conditions for their growth.

    Outbreaks of botulism arising from consumption of vegetables in oil – including garlic, olives, mushrooms, beans and hot peppers – have mostly been attributed to the products not being properly prepared.

    Vegetables in oil can be made safely. In 1991, Australian regulations stipulated that this class of product (vegetables in oil) can be safely made if the pH (a measure of acid) is less than 4.6. Foods with a pH below 4.6 do not in general support the growth of food-poisoning bacteria including botulism.

    So keep food out of the danger zone to reduce your guests’ risk of getting food poisoning this summer. Check out other food safety tips and resources from CSIRO and the Food Safety Information Council, including testing your food safety knowledge.

    Cathy Moir, Team leader, Microbial and chemical sciences, Food microbiologist and food safety specialist, CSIRO

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The Conversation

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  • Quick Healthy Recipe Ideas

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    “It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!! ”

    We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:

    Don’t Forget…

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  • Which Osteoporosis Medication, If Any, Is Right For You?

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    Which Osteoporosis Medication, If Any, Is Right For You?

    We’ve written about osteoporosis before, so here’s a quick recap first in case you missed these:

    All of those look and diet and/or exercise, with “diet” including supplementation. But what of medications?

    So many choices (not all of them right for everyone)

    The UK’s Royal Osteoporosis Society says of the very many osteoporosis meds available:

    ❝In terms of effectiveness, they all reduce your risk of broken bones by roughly the same amount.

    Which treatment is right for you will depend on a number of things.❞

    …before then going on to list a pageful of things it will depend on, and giving no specific information about what prescriptions or proscriptions may be made based on those factors.

    Source: Royal Osteoporosis Society | Which medication should I take?

    We’ll try to do better than that here, though we have less space. So let’s get down to it…

    First line drug offerings

    After diet/supplementation and (if applicable) hormones, the first line of actual drug offerings are generally biphosphates.

    Biphosphates work by slowing down your osteoclasts—the cells that break down your bones. They may sound like terrible things to have in the body at all, but remember, your body is always rebuilding itself and destruction is a necessary act to facilitate creation. However, sometimes things can get out of balance, and biphosphates help tip things back into balance.

    Common biphosphates include Alendronate/Fosamax, Risedronate/Actonel, Ibandronate/Boniva, and Zolendronic acid/Reclast.

    A common downside is that they aren’t absorbed well by the stomach (despite being mostly oral administration, though IV versions exist too) and can cause heartburn / general stomach upset.

    An uncommon downside is that messing with the body’s ability to break down bones can cause bones to be rebuilt-in-place slightly incorrectly, which can—paradoxically—cause fractures. But that’s rare and is more common if the drugs are taken in much higher doses (as for bone cancer rather than osteoporosis).

    Bone-builders

    If you already have low bone density (so you’re fighting to rebuild your bones, not just slow deterioration), then you may need more of a boost.

    Bone-building medications include Teriparatide/Forteo, Abaloparatide/Tymlos, and Romosozumab/Evenity.

    These are usually given by injection, usually for a course of one or two years.

    Once the bone has been built up, it’ll probably be recommended that you switch to a biphosphate or other bone-stabilizing medication.

    Estrogen-like effects, without estrogen

    If your osteoporosis (or osteoporosis risk) comes from being post-menopausal, estrogen is a very common (and effective!) prescription. However, some people may wish to avoid it, if for example you have a heightened breast cancer risk, which estrogen can exacerbate.

    So, medications that have estrogen-like effects post-menopause, but without actually increasing estrogen levels, include: Raloxifene/Evista, and also all the meds we mentioned in the bone-building category above.

    Raloxifene/Evista specifically mimics the action of estrogen on bones, while at the same time blocking the effect of estrogen on other tissues.

    Learn more…

    Want a more thorough grounding than we have room for here? You might find the following resource useful:

    List of 82 Osteoporosis Medications Compared (this has a big table which is sortable by various variables)

    Take care!

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