Posted on November 5, 2014 in Addiction

Can an Epilepsy Medication Reduce the Risks for Morphine Addiction?

Morphine is a powerful opioid medication commonly used to treat certain forms of moderate and severe pain. Like all other opioid medications, it creates changes in normal brain chemistry that can potentially lead to the onset of drug addiction. In a study published in September 2014 in the journal PLOS One, a team of American researchers explored the usefulness of an epilepsy medication called carbamazepine in lowering the amount of morphine given to the average patient. Such a reduction in morphine doses could substantially diminish the risks for morphine addiction.

Morphine

Morphine is the main active ingredient found in most of the opium plants harvested throughout the world. Illicit drug manufacturers use this naturally occurring opioid substance to make the powerful drug heroin. Pharmaceutical manufacturers use it to create pain-relieving medications. Doctors commonly use morphine-based medications to address severe pain in people waiting for surgery or recovering from surgery, although use may also occur in other appropriate medical circumstances. Available forms of morphine include tablets, extended-release tablets, capsules, extended-release capsules, oral liquids and injectable liquids.

Morphine is a highly addictive substance on par with heroin. In fact, when any given person consumes heroin, the body converts this drug to morphine before it reaches the brain. As a rule, doctors try to limit the risks for morphine addiction by selectively using the medication and strictly controlling the amount prescribed to any individual. Some long-term morphine users develop a physical need for the medication, a state known medically as physical dependence. However, when it comes to opioid medications, dependence and addiction are not the same thing. While some people develop an addiction, especially when they use morphine improperly or without a prescription, most legitimate users affected by dependence never develop addiction’s classic symptoms of severe life dysfunction.

Carbamazepine

Carbamazepine is an anticonvulsant or anti-seizure medication that produces its beneficial effects by slowing down any excessive or unusual electrochemical communication between the brain’s nerve cells. Doctors commonly prescribe this medication as a treatment for the recurring seizure disorder known as epilepsy. Additional established uses of carbamazepine include relief of a highly painful facial nerve condition called trigeminal neuralgia, relief of the manic and mixed manic/depressive episodes that characterize the mood disorder bipolar I disorder, relief of substance withdrawal, relief of PTSD (post-traumatic stress disorder) and relief of major depression. In the U.S., available forms of the medication include tablets, extended-release tablets, chew tabs (chewable tablets), oral liquids and extended-release capsules.

Reduction of Addiction Risks

In the study published in PLOS One, researchers from the Indiana University School of Medicine and the University of Arizona College of Medicine used laboratory testing on rats and mice to explore the usefulness of carbamazepine in improving the pain relief provided to morphine-using patients and reducing the amount of morphine prescribed to any given individual. The specific context for morphine use in the study was the relief of pain stemming from significantly damaged nerve tissue. The researchers’ work was inspired, in part, by awareness of the risks for opioid dependence (and, by extension, opioid addiction) in long-term morphine recipients. In addition, they wanted to investigate the possibility of avoiding a painful condition called opioid-induced hyperalgesia, which sometimes appears in people who take morphine or other opioid medications for extended periods of time.

During the study, the researchers gave morphine to a group of rodents with damaged nerve tissue. After about three weeks, the effectiveness of the medication dropped and the animals started to experience substantial pain symptoms. Typically, the response to such an occurrence would be an increase in the amount of morphine supplied per dosage. However, instead, the researchers combined morphine treatment with carbamazepine treatment. This approach produced several significant benefits. First, it re-established effective pain relief for the nerve-damaged rodents. In addition, it reduced these animals’ level of exposure to opioid-related side effects. In addition, the combination of morphine and carbamazepine allowed the researchers to reduce the amount of morphine required for appropriate treatment.

The study’s authors note that carbamazepine apparently reverses some of pain-increasing side effects that can appear in the context of long-term morphine use. In addition, they note that anecdotal reports from doctors indicate that the results they found in their animal study also apply to humans receiving morphine for their pain symptoms. The authors believe that the combined use of carbamazepine and morphine could help reverse the dangerous, potentially addiction-promoting trend toward increasing opioid dosages in pain management.

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