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One of the biggest challenges for those in addiction recovery is the limited list of options for the management of acute and chronic pain. While most issues are fully covered by typical over-the-counter medications like NSAIDs and other anti-inflammatory agents, sometimes one requires more substantial medication. This is particularly true when undergoing a serious dental or surgical procedure. Those with a history of substance use, particularly those with opioid use disorders, should not use hydrocodone, oxycodone, or other highly addictive opioid painkillers, which are typically prescribed in these cases.

Today, researchers at Wake Forest School of Medicine have made massive strides towards resolving this problem. Their recent animal trials have revealed an exciting new possibility: a safe, non-addictive painkiller to fight the American opioid crisis.


Called AT-121, Wake Forest and Astraea Therapeutics’ new chemical compound has a dual therapeutic action. This means that it suppressed the addictive effects of opioids while also producing morphine-like analgesic effects in test subjects.

Professor of physiology and pharmacology Mei-Chuan Ko, Ph.D., states that the researchers, “found AT-121 to be safe and non-addictive, as well as an effective pain medication. In addition, this compound was also effective at blocking abuse potential of prescription opioids, much like buprenorphine does for heroin, so we hope it could be used to treat pain and opioid abuse.”

The study demonstrated that AT-121 showed the same degree of pain relief as an opioid medication but at a 100 times lower dosage than morphine. It also blunted the addictive effects of oxycodone at that dose. AT-121 lacks the side effects associated with medications that act solely on the mu-opioid receptor, such as itching, tolerance, dependence, and respiratory depression.


It’s important to note that this medication is still in the process of primate trials. It has not yet been tested on humans. Additionally, although initial research is promising, further study is required to fully understand the short- and long-term effects of AT-121. No medication should be considered a miracle cure, and it should only be used under the supervision of a medical doctor.

Today, AT-121 is entering the next phase of its vetting. Preclinical studies will begin in an effort to collect safety data before applying it to the FDA for clinical trials with human participants.


In Wake Forest’s study, researchers observed that the primate subjects were no more likely to self-administer AT-121 than saline. This indicates that the medication is non-reinforcing and likely is not acting on the reward section of the brain. Ko says that this is the “first [painkiller] demonstrated in a nonhuman model to have such a promising profile.”

This data has a lot of far-reaching implications. First, those in recovery would have access to a powerful, non-addictive medication for managing their pain. The nociception/orphanin FQ peptide action of AT-121 means that the opioid-like effects (and side effects) are dulled, resulting in safe medication for all.

The other side of this drug is its potential to begin chipping away at America’s opioid epidemic. If AT-121 is approved by the FDA, it could rapidly replace problematic, highly addictive opioids like oxycodone and fentanyl in doctor’s offices. While black market exchanges would still happen, ideally the supply would vastly decrease and those with severe pain would not be prescribed these life-altering medications any longer.


BRC Recovery Support offers ongoing recovery services for those in addiction treatment. From sober transportation to individualized sober counseling, our team will work with you to build a successful life in sobriety. If you or a loved one could benefit from these services, feel free to reach out.