An article in today’s newspaper touts the discovery by Stanford University and their development of yeast that can produce hydrocodone. This is a synthetic opioid also known by the trade names Vicodin, Norco, or Lortab. It is a moderately powerful oral pain medication and has been one of the most highly prescribed pain drugs in the United States. Of all the hydrocodone produced worldwide, 90 percent or more is used in this country. Unfortunately, this makes it one of the most abused drugs in the country.
Stanford University has found a yeast that when mixed with sugar will produce hydrocodone as a byproduct. Most of us are familiar with yeast that is used to make bread or mixing a yeast with sugar and that will produce alcohol. Now a type of yeast has been produced that when mixed with sugar will produce an opioid. The benefit is that maybe it will lower the production cost of the drug and make this painkiller more available worldwide, especially where there is a lack of medication.
Pros Versus Cons
The larger question beyond the medical breakthrough is whether this is a good development. In the United States, we currently have an epidemic of opioid abuse and significant over-prescribing with misuse. Pain can be treated with multiple different strategies; medication is only one of the possible methods. Unfortunately, it has become the quick and easy solution for physicians. For patients, more effective strategies often require the patient to do more work, such as exercise, strengthen and stretch muscles, lose weight, eat differently, and take more control of their lives. In the rest of the world, often people have more realistic view of life and their bodies, and do not resort necessarily to a pill for pain relief. Readily available pain medications have already been shown to be a problem in the United States.
The other major issue is if Stanford University has been able to develop a yeast to cheaply and quickly manufacture an opioid, how long will it be before this technology gets into the hands of illegal drug manufacturers? We know that illegal drug use is a multi-billion dollar business. It is likely that someone is already trying to either steal a copy of the yeast, or develop their own yeast for the same purpose. The illegal drug trade and opioid addiction in the United States is a major problem. Finding an easy way to home brew opioids appears to be just around the corner. As a pain physician, this is likely to just be another problem and will be a boon for drug addiction centers and criminals. The cost to society may be much worse than making a drug cheaper and more available. Despite its potential, this may be the next societal disaster.