Opioid withdrawal symptoms blocked by gout treatment drug

A study from researchers at the University of Calgary has found that the drug probenecid, used to treat gout, is effective at reducing symptoms associated with opiate withdrawal in mice.

Lead researcher Tuan Trang from the Hotchkiss Brain Institute and the University of Calgary’s School of Veterinary Medicine says that the results could eventually aid people in fighting addiction to opioids, one of the most pressing health crises facing Canada today.

In a new paper published in the journal Nature Medicine, Trang and colleagues focused on immune cells in the brain and spinal cord called microglia which are thought to be connected to opioid withdrawal symptoms. The team found that by suppressing microglia cells in rodents experiencing opioid withdrawal, the negative symptoms were reduced, a result which Trang calls “a new potential therapeutic target.”

Opioid gout treatment connection is unclear…

Because of their severity, opioid withdrawal symptoms such as muscle aches, joint pain, nausea and diarrhea are known to keep addicted drug users using, thus acting as an impediment to ending addiction. Yet so far, research into addiction has not clearly revealed the factors going into symptom manifestation and its connection to continued use, say the new study’s authors.

“Withdrawal is therefore a key determinant of opiate use in dependent individuals, yet its underlying mechanisms are poorly understood and effective therapies are lacking,” say the authors, who include researchers at University of Toronto, University of California Irvine, Université Laval along with those from the University of Calgary.

Probenecid, which is used to treat gout and hyperuricemia, works to increase uric acid excretion through the urine. The drug has already been clinically approved – which is a plus for the new treatment possibilities – but it has since been taken off the market in Canada in favour of more effective medications. “We realized there is … a drug that was already clinically approved to treat gout that effectively blocks the target on these cells,” said Trang to the CBC. The researchers are now working on a clinical trial to test the use of probenecid for opioid withdrawal symptoms.

In 2016, an estimated 914 people died of illicit drug overdoses in the province of BC -the highest total since records were first collected 30 years ago. Alberta saw 338 deaths linked to either fentanyl or another opioid between January and September of 2016 alone.

A report by Canadian physicians in the November issue of the Canadian Medical Association Journal stated that the use of prescription opioids in Canada over the past 20 years has been climbing steadily, to the point where by 2010, more than one in 20 adults and as many as one in six adolescents were using opioids for non-medical purposes.

Co-author of the report, Prof. Benedikt Fischer of the Centre for Addiction and Mental Health in Toronto, told the CBC that it’s not too late for the government to act to curb the crisis, saying that physicians need new guidelines for prescribing opioids only in exceptional cases along with real-time electronic prescription monitoring systems for physicians to consult before prescribing opioids.

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