A Safer Opioid? Scientists Use Sodium To Reduce Harmful Effects of Fentanyl

Prescription Drug Concept

Fentanyl is a powerful synthetic opioid that is 50 to 100 times more potent than morphine. It is often prescribed to manage severe pain, but it also has a high potential for addiction and overdose. Long-term use of fentanyl can lead to physical dependence, tolerance, and withdrawal symptoms.

A mouse and cell study has yielded promising results, offering hope that scientists may be able to mitigate the harmful effects of fentanyl, the world’s deadliest opioid, and potentially other drugs as well.

Sodium, a commonly found element on Earth, may offer the potential for scientists to create opioids or other drugs with far reduced side effects.

Scientists from USC, Washington University in St. Louis, and Stanford University have published a study in the journal Nature, in which they showed that by chemically connecting fentanyl to the sodium pockets within nerve cell receptors, they were able to prevent the harmful side effects of the drug while still effectively reducing pain.

Further study is needed but the results hold promise – not just for drug development but for addressing the nation’s crisis of addiction and overdose. Nearly 70,000 Americans died in 2020 of an opioid overdose – most of them from the synthetic opioid, fentanyl, according to the National Institute on Drug Abuse. In the 1990s, the Food and Drug Administration approved the use of fentanyl to ease severe pain in cancer patients but it has since made its way into the streets, worsening the national crisis of opioid abuse.

“In its current form, fentanyl is like a weapon of mass destruction,” said Vsevolod Katritch, a computational scientist at the Bridge Institute at USC Michelson Center for Convergent Bioscience and a corresponding author of the study. “Our new collaborative work suggests that we could redesign the drug in such a way that we convert this frequent overdose killer to a much more benign but still effective analgesic.”

Drugs of all kinds are designed to target certain receptors on nerve cells known as GPCRs, or G-protein coupled receptors, which act as signal transmitters. These receptors are like switches that mediate a drug’s intended effect on the brain and body, but also the unintended side effects. In the case of fentanyl, the most potent painkiller of all opioids, patients may suffer from addiction and may die from respiratory arrest.

Katritch noted that he and his fellow scientists Ray Stevens and Vadim Cherezov at the Bridge Institute and the USC Dornsife College of Letters, Arts, and Sciences have been looking at the potential of the sodium mechanism since they first identified it within adenosine and opioid receptors about a decade ago.

Katritch and his collaborators said that although further study is needed to prove that their less harmful version of fentanyl will work in humans, the results have opened a new door for scientists to potentially improve the safety of painkillers.

“We are desperately looking for ways to maintain the analgesic effects of opioids while avoiding dangerous side effects such as addiction and respiratory distress that too often lead to death,” said corresponding author Susruta Majumdar of Washington University in St. Louis. “Our research is still in its early stages, but we’re excited about its potential for leading to safer pain-relieving drugs.”

Beyond opioid receptors, noted Katritch, this work opens a new molecular design concept for dozens of other GPCRs where such functional conversion in existing drugs would be desirable.

Reference: “Structure-based design of bitopic ligands for the µ-opioid receptor” by Abdelfattah Faouzi, Haoqing Wang, Saheem A. Zaidi, Jeffrey F. DiBerto, Tao Che, Qianhui Qu, Michael J. Robertson, Manish K. Madasu, Amal El Daibani, Balazs R. Varga, Tiffany Zhang, Claudia Ruiz, Shan Liu, Jin Xu, Kevin Appourchaux, Samuel T. Slocum, Shainnel O. Eans, Michael D. Cameron, Ream Al-Hasani, Ying Xian Pan, Bryan L. Roth, Jay P. McLaughlin, Georgios Skiniotis, Vsevolod Katritch, Brian K. Kobilka and Susruta Majumdar, 30 November 2022, Nature.
DOI: 10.1038/s41586-022-05588-y

The study was funded by the National Institute on Drug Abuse and the National Cancer Institute. 

4 Comments on "A Safer Opioid? Scientists Use Sodium To Reduce Harmful Effects of Fentanyl"

  1. Sodium explodes in water. Detonating nerve cells really tamps down the cravings.

    Neat idea though. I wonder if a technique like this could work for other drugs with side-effects.

  2. Jessamyn Butler | January 27, 2023 at 8:24 am | Reply

    This article is just another lazy journalist’s repetition of the gauze narrative prepared by the cdc, dea, and the us govt. You left out the most important words when reporting on fentanyl. The LEGALLY PRESCRIBED fentanyl pain medication fentanyl is safe when used exactly as directed. You forgot to mention – or maybe didn’t forget and were just going with the shock tactics – that 98% of the fatal fentanyl overdoses came from street-bought ILLICITLY MANUFACTURED FENTANYL, not the medication used for severe intractable pain. You did, however, get one part correct, though you phrased it to be a “bad thing” instead of an inconsequential fact: legally prescribed fentanyl (and ALL legally prescribed opioids) carry the possibility of “tolerance, dependency, and withdrawals” because these are the nature of the substance. ADDICTION is NOT comparable to these other words – they are separate entities. AND MANY MANY other medications cause the previously mentioned conditions: antidepressants, cardiac, diabetic, and other meds! There are tons of meds that you MUST be tapered off of, or you will experience harmful effects.
    Get with the REAL program, here. We are looking for REAL information, not these stupid incorrect articles that quote the flawed statistics of the us govt’s ABC agencies. (Shaking my head in disgust)

  3. Jessamyn Butler | January 27, 2023 at 9:48 am | Reply

    I agree with you Jessamyn and I’d like to add that you have to have an addictive personality people don’t understand that. Doctors are looking at patients in a whole instead of separately acute vs.chronic pain when it comes to pain medications.I’ve had chronic pain since childhood and been on opiates all my life the problem is Dr’s have to learn their patients because the ones that are getting legal opiates from Dr,s and abusing them to get high are the one’s making it difficult for the people who truly need them without out my medications I cannot function and the Dr’s say physical therapy heat or ice tylenol works yes for some people with acute pain not for long term chronic pain.The system is so broken and Big Pharma they need to go as well as the whole government it’s so sad because it’s all about money and greed and because of that people like myself suffer.

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