Two recent studies suggest that genotyping may enable clinicians to base therapies on individual patients’ potential responsiveness to opioid drugs’ therapeutic effects and vulnerability to their harmful effects.
Study patients with HIV–hepatitis C coinfection progressed to successive degrees of severity of liver fibrosis 9 years sooner than those infected with HCV alone. Further findings from the study suggest that suppressing HIV with antiretroviral medications may slow HCV-related liver fibrosis.
A trial of buprenorphine/naloxone (Bup/Nx) showed no evidence that the medicine was associated with liver damage. The drug gave results similar to those of methadone. The study data indicate that although most patients can be treated safely with either methadone or Bup/Nx without major concern for liver injury, clinicians are advised to continue to monitor the liver health of their patients who are on methadone or Bup/Nx therapy.
Researchers report a significant advance in the search for medications that can suppress pain but avoid opioids’ abuse potential and other undesirable CNS effects. A new compound reduces mouse responses in animal models of neurogenic and chronic inflammatory (e.g., arthritic) pain. The compound, called UB937, enhances the natural pain-killing activity of the neurotransmitter anandamide, and exerts its analgesic effects entirely in peripheral tissues, without entering the brain.
Prenatal drug exposure can have behavioral effects that last well into adulthood, according to two studies of adult monkeys prenatally exposed to cocaine. In the first study, drug-exposed monkeys exhibited less flexibility than controls in adjusting to changing circumstances; in the second study, drug-exposed males exhibited a greater preference than controls for having rewards right away, a sign of impulsivity.
Dr. Volkow discusses NIDA’s efforts to develop effective antismoking treatments for populations with persistently high rates of smoking, such as people with psychiatric disorders, high school dropouts, and Native Americans.