Nausea Drug Can Help Reduce Symptoms in Opiate Withdrawal

Opioid addiction, whether illegal heroin or legally prescribed medications, is a growing problem in the United States. There are companies that are working on opioid substitutes or tamper-proof opioids, but as of now morphine is still the painkiller most prescribed by doctors after surgery, and codeine is in many prescriptions, including cough suppressants. In 2007, 12.5 million Americans 12 or older were using prescription opioid medications for non-medical purposes according to the National Survey on Drug Use and Health.

Larry F. Chu, M.D., assistant professor of anesthesia at the School of Medicine, Stanford University, said that opioid abuse is rising at a faster rate than any other illicit drug use, but only about a quarter of those who are opioid dependent seek treatment. Chu said that one barrier to treatment is that when a person stops taking the drugs suddenly it is like “bad flu” with agitation, insomnia, diarrhea, nausea and vomiting.

Chu was among a group of Stanford University researchers looking for ways to prevent the symptoms of withdrawal and was the lead author of the study on their research published in the Journal of Pharmacogenetics and Genomics. The researchers say that a drug already approved by the FDA appears to avoid some of the problems that accompany withdrawal. The drug, ondansetron, is approved to treat nausea and vomiting for those receiving chemotherapy. The scientists warned that the drug will not solve the problems that occur with the continued use of the opioids, but in tests with mice it reduced the symptoms of their addiction, jumping and pain sensitivity.

Since the drug was already approved for use in humans, the scientists then used the drug in eight healthy humans who were not opioid dependent. The group received a single large dose of morphine and in another session at least a week later they took ondansetron in combination with the morphine. The participants then completed questionnaires to assess their withdrawal symptoms. Similar to the mice, humans receiving ondansetron with the morphine had a significant reduction in withdrawal symptoms.

Ondansetron is completely different from other treatments used to treat addiction. One drug, clonidine, causes severe side effects and requires close medical supervision. Methadone and buprenorphine are not satisfactory because they replace the opioid addiction with their own addiction. “It’s like replacing one drug with another,” said co-investigator Gary Peltz, M.D., Ph.D., professor of anesthesia.

A clinical study to test another ondansetron-like drug for opioid withdrawal is planned in a larger group of healthy humans, and the research team will continue to test ondansetron in the treatment of opioid addiction. The scientists warn that ondansetron will not resolve the problems of continued use of painkillers. It will treat the symptoms of withdrawal, but not the addiction.