This article is in a series on Medications for Pain. What are your choices? How do various medications work? What are the pros and cons? How about side effects?

What are some medication advances coming soon?

1. Improvements to opiates (narcotics)
While opiates or narcotics are sometimes helpful, they have more than their share of negatives. Selective narcotics, which give pain control but have fewer side effects, are being developed. Instead of working everywhere in the body, they’re being designed to work at pain sites, but not at so many other sites (for example, in your digestive tract) where they cause the problematic side effects. Another improvement is medication that will decrease side effects from opioids.

2. Different delivery systems for narcotics
Narcotics are being developed to be given either by inhalation (in inhalers, like asthma medication) or through the skin inside your mouth or nose (by rubbing a little gel there). Why? Medications used in these ways work faster and can last for a shorter time. These delivery systems may be very helpful for people who have break-through pain, which are short-duration spikes of pain. These short flares of pain can be hard to treat because medication didn’t work fast enough, or lasted too long. And, because of other advantages of getting medication into your body in these ways, lower overall dosages can be used, which also mean fewer side effects.

3. Using medications more safely
Research is being done to see how to use the medications we have now more safely. For narcotics, how do we avoid tolerance (tolerance = your body gets used to a dosage, so to get the same benefit, the dosage must increase). We’re finding that another pain medication, Ketamine, may be helpful to prevent tolerance.

4. Using genetics to predict which medication is right for you
Depression research is studying how genetics can predict which antidepressant is right for you. No guessing, no waiting – just a simple blood test which can be used to say, This one should work the best. We’re not at this stage yet with pain medication, but my hope is that such tests will be available soon. We could tell, Lyrica versus Neurontin? Cymbalta or Effexor? This would save a lot of time  – not using medications which won’t work – and prevent a lot of side effects.