New ways to treat the pain of the opioid crisis

Pain is an important issue for both society and health care. With recent news showing effectiveness of gene silencing in the prevention of pain transmission, combined with people living longer with increased comorbidities and the unresolved US and potential UK current opioid crises, the development of novel and effective pain treatments will surely throw the matter of pain relief into even starker light. Across Europe, an estimated 100 million people have chronic pain, while the number is more than 50 million adults in the USA and estimates in the UK are at approximately one in seven of the population. These high numbers are complicated by the variety of causative conditions and the variance in pain severity, frequency, and onset. Individuals living with chronic pain can have huge disruptions to their ability to work and enjoy a healthy quality of life. In the USA, the annual burden on society has been estimated at $560 635 billion. The increasing frequency of individuals with chronic pain as the result of chronic diseases and postoperative pain have directly led, over the past two decades, to the over prescription and misuse of opioids. What is referred to as the opioid crisis describes both the medical overuse and subsequent addiction by patients to opioid prescription and synthetic drugs. Opioid side-effects include poor coordination, mood swings, depression, and anxiety combined with a dependence on the drugs. The damage to an individual can affect all facets of dayto-day life with the increased risk of fatal overdose. Although the crisis is firmly established in the USA, reports of a 400% increase in opioid prescription over the past decade and an increase in deaths from fentanyl from eight to 135 per year in the UK suggest this problem is not limited to North America. Opioids are a diverse family of painkillers, which include fentanyl, oxycodone, codeine, hydrocodone, and other compounds. In the late 1990s, the addictive qualities of these drugs were underestimated, leading to their widespread prescriptive use as post-surgical and chronic pain analgesics. In early 2019, an estimated 130 people per day were dying from opioid-related drug overdoses, 2 million people were misusing first-time opioid prescriptions, and almost 33 000 deaths were attributed to overdosing with synthetic non-methadone opioids in the USA alone. In recognition of this epidemic, governments and health-care organisations have used a wide range of approaches to counteract the increase in addiction and addiction-related deaths. In 2012, the US Food and Drug Administration (FDA) developed a risk evaluation and mitigation strategy for all health-care professionals, using extended-release and long-acting opioid analgesics. This programme sought to educate health-care professionals on proper prescribing practices via training and distribution of learning materials. The US Department of Health and Human Sciences (HHS) implemented a