Pain & Addiction

My last article explained why I chose to be a Reflexologist after 21 years in Biomedical Genetic Research, describing the logical link between the two.

This article looks at a specific area of my research and how it relates to therapies I now offer.

15 years ago, I researched the genetics of pain, to help develop painkilling drugs. Pain relief was, and still is, deemed a huge area of unmet therapeutic need. We analysed genes in a family with Congenital Insensitivity to Pain, where several children did not feel pain. They could break bones or cut themselves and, because they did not feel it, cause a lot of damage.

I found the affected children had inherited two copies of a defective variant, one from each parent, in a gene called Nav1.7, making the gene no longer functional. The parents were normal (asymptomatic, heterozygote carriers) because they each had a normal (wild type) as well as a defective copy.

Researchers also found a mutation in the same gene in another family and we each published in Nature and Human Molecular Genetics. Other mutations in the gene were also discovered, that cause hypersensitivity to pain.

These mutations validated Nav 1.7 encoding a sodium channel, SCN9A, as a target for painkilling drugs to block the gene, just as the mutation stopped the gene working.

However, biology is not that simple ….

For 15 years since, researchers have been looking for painkillers against this gene target. This month the scientific journal Nature reported that this has not been successful, with failed attempts in all 9 drug candidate clinical trials, stating, “just because a target is genetically validated, doesn’t mean it’s druggable”. Efforts are still underway to find ways of blocking this channel, the latest being tarantula venom peptides.

To my mind, genetics enables us to unravel mechanisms of pain, but it doesn’t mean that a drug to interfere with that process is the answer to dealing with pain.

Whilst painkillers may be useful for short term pain, the more I am aware of chronic (long term) pain management, the more I question the rationale for blocking pain which is seemingly ineffective; pain is there for a reason and the body develops resistance to pain killers, until the mind/ body heeds its signals. It calls us to tend to an injury and prevent further damage. It is the body asking to be noticed, not masked by drugs or ignored by the mind. It is why consultant pain specialists offer CBT and take patients off painkillers, recognising there is an emotional element to pain and that pain comes back stronger once the effects wear off.

We know that pain signals/gene expression of Nav1.7 goes up when there is inflammation, which is present immediately after an injury or when we are stressed.

There are also many undesirable side effects with long term use of painkillers which do not treat the root cause of inflammation and pain; non-steroidal anti-inflammatories (NSAIDs) are linked to kidney cancer. Co-codamol causes constipation and is addictive as are other opioid based drugs. Paracetamol would fail a clinical trial today due to liver injury and its side effects can lead to costly hospital admissions.

Prescription opioids such as OxyContin in the US have tragically led to a mass epidemic of addiction, with tens of thousands of opioid related deaths per year. A federal court case is imminent with some 2,000 lawsuits against the pharmaceutical company Purdue, founded by the G.P Sackler brothers, with settlements estimated to run to half a trillion dollars.

Addictions in general, often occur as a way of masking painful thoughts or emotions and if these are ignored, can manifest as physical pain and disease.

Addictive comfort foods such as chocolate, alcohol, carbohydrate rich foods such as pastries, cakes, bread, pasta and certain fats in our diet, are also pro-inflammatory, which will make pain worse. We are also often deficient in anti–inflammatory foods, such as omega-3 oils, which we cannot manufacture ourselves, however, they are essential building blocks for our health.

There is a therapeutic place for holistic methods of pain management, taking into account diet, lifestyle, thoughts and emotions. The specific place in the body where pain and disease is felt can indicate the nature of thoughts and feelings.

As a holistic therapist I use a variety of tools and techniques and work at the body, mind and emotional level to support clients, bringing them into better balance for health and wellbeing, helping establish root causes of disease, facilitating and empowering them to manage and release pain, to learn and grow from the experience and realise their full potential. Clients have reported being pain free for the first time, following treatments with me, after decades of long term pain.

Nature Reviews| Drug Discovery May 2019 PP 321 – 323 Human Molecular Genetics June 2007 pp 2114 – 2121 Nature volume 444, 2006 pp 894–898

Article written by Tracy Mills for Local People Magazine, June 2019 issue.