Nalbuphine and Addiction: From the Basic Science to Clinical Set

Abstract

Opioid drugs are currently the main treatment for acute and chronic pain control. Over the past three decades, misuse of opioids has led to rising worldwide addiction/dependence rates and overdose deaths. In the United States of America, this opiate crisis scenario, which in 2016 alone resulted in the estimated death of over 64,000 people, was characterized as the Opioid Epidemic and declared as a national public health emergency.1 Nalbuphine (C21H27NO4) is a synthetic kappa receptor agonist opioid and partial Mu receptor antagonist,2,3 which has been synthesized in an attempt to provide analgesia without the undesirable side effects of pure agonists.4 Thus, the central analgesic action and lower Nalbuphine addiction/dependence potential would be exerted by the agonist action on kappa receptors, while its Muopioid agonist action would be responsible for its analgesic potential, equivalent to morphine and its lower respiratory depression.5