Thursday, December 10, 2009

Opioids In The News Part 1

Opioids In The News Part 1: Does Morphine Stimulate Cancer Growth?

Morphine was first isolated in 1803 by the German pharmacist Friedrich Wilhelm Adam Serturner, who named it 'morphium' after Morpheus, the Greek god of dreams.

Let's take a look at some recent, amazing associations made by the media regarding opioids!

As GeriPal stated:

Over the last week Reuters, ABC news, MSNBC,
BBC News, and more than 75 other outlets reported on how two "two new studies
add to growing evidence that morphine and other opiate-based painkillers may
promote the growth and spread of cancer cells."

Pallimed, on the same topic stated:

The headlines all blared hyperbolic and false
oversimplifications of the impact of the research. Now I am no opioid apologist,
but I do have to recognize that I spend a great deal of my education to
patients, families, staff, and other doctors de-stigmatizing opioids so they may
be used effectively for good pain control while balancing their manageable
risks. So while I nearly always am defending appropriate opioid prescribing, I
also want to recognize if there is potential harm in its use.

GeriPal goes on to state:

All these articles (most stemming from an
initial Reuters report) discussed the recent presentation by a group from the University of Chicago on the mu-opioid antagonist
methylnaltrexone (otherwise known as Relistor or “that new opioid induced
constipation medication”). This work, as presented at a meeting in Boston, revealed that use
methylnaltrexone prevented tumor-cell proliferation and migration in cultured
lung cancer cells.

The most important take home point is that none
of these studies actually looked at opioid use (although many of the news
articles vaguely cite these studies as evidence for morphine’s deleterious
effects on cancer). Even if you want to argue that these were high quality
studies and there is a clear benefit of regional anesthesia, opioids should not
be singled out as the cause.

Their take home message = “There is no clinical evidence that morphine, or any other opioids, cause real harm through stimulating cancer growth.” The evidence will definitely have to be more substantial before we sound the alarms for the general public!

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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia:

Journal of Palliative Medicine - Table of Contents

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