By Haidita Celestine
Many Canadian seniors may be suffering in pain needlessly according to Rowan Hamilton, Research Director of Humn Pharmaceuticals of Winnipeg. Hamilton asserts that “despite the fact that lidocaine is on the World Health Organization’s list of Essential Medicines (a list of the most important medications needed in a basic healthcare system) most people are unaware of how well it relieves a wide range of pain conditions.”
For those who know Hamilton, a herbalist, wholistic dermatologist, student of Traditional Chinese Medicine and a graduate of the School of Herbal Medicine in England, it may come as a bit of a surprise to hear him speaking of the benefits of a synthetic drug. Hamilton notes, however, that while some people almost always prefer ‘natural’ alternatives, the only naturally occurring local anesthetic is cocaine.
In the late 1880s cocaine was in fact the very first local anesthetic used in dentistry and an improvement on the previous approach: copious amounts of alcohol. People liked it because it acted quickly and didn’t last too long; they also noticed the feeling of euphoria that went with cocaine use and many dentists developed a dependence on the substance. In the early 1900s, procaine / novocaine was introduced with all the desired benefits of cocaine but without its addictive and heart racing side effects. Lidocaine, however, became the dentist drug of choice when it was made commercially available in the late 1940s.
Lidocaine was first synthesized under the name xylocaine by Swedish chemist Nils Löfgren in 1943. The most significant difference between lidocaine and earlier local anesthetics was its stability in water. In practical terms this meant that lidocaine, unlike procaine, did not need to be prepared freshly before each injection. It could be prepared ahead of time and stored until needed. As a local anesthetic water stability also allowed it to remain near the point of administration longer; so it isn’t as easily spread throughout the body and its numbing effects remains close to where it is applied.
Further, lidocaine was the first amino amide-type local anesthetic; until its discovery, local anesthetics were all “esters”. Amide-type anesthetics have a major patient care advantage Hamilton says. “Ester type anesthetics are much more likely to cause allergic reaction compared to the amide type local anesthetic.” The other advantage of an amide-type anesthetic is that its numbing affect lasts longer. The amide linkage allows the drug to have a longer lasting affect because the circulatory system doesn’t break it down as easily as it does an ester.
As Hamilton puts it, “all that, is a long way of saying that lidocaine can take up temporary residence in the sodium channel of the nerves and prevent pain signals not only from travelling to the brain, but from being initiated at all. And it does that without addiction, fewer unwanted side effects and much fewer allergic reactions.”
In the search for ever-improving pain relievers, though, the benefits of lidocaine seem to have been largely forgotten. The medical marketplace for pain treatment since Lidocaine’s creation has been dominated by pills delivering Non-Steroidal Anti-inflammatories (NSAIDs) and Opiates. The most common NSAIDs on sale are ASA (Acetylsalicylic acid), ibuprofen, diclofenac and acetaminophen. Opiates include morphine, codeine and oxycodone. Consumers, however, are increasingly concerned and aware of the dangers and limitations of these drugs. “For some of the same reasons that lidocaine replaced cocaine and novocaine, Humn Pharmaceuticals is re-introducing lidocaine as a safer alternative to NSAIDs and a complement to opiates: fewer side effects and no addiction.” states Hamilton.
Further, in TPR20, Humn Pharmaceuticals is presenting lidocaine in a topical cream formulation with other complementary ingredients including menthol. “TPR stands for Topical Pain Relief,” says Hamilton. “As a medicated cream, it goes where it is needed, when it is needed. It is applied on the skin, at the point where pain is felt, that way it doesn’t go through the stomach, or the liver or the kidneys, where many drugs leave a trail of damage.”
The American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons has also recognized the value of lidocaine. In their 2009 Clinical Practice Guideline, they strongly recommended that “all patients with localized neuropathic pain are candidates for topical lidocaine.”
“I’m very happy to be associated with Humn Pharmaceuticals,” says Hamilton. “They didn’t invent lidocaine and the drug is long past its patent date. That doesn’t diminish its value as a pain reliever but it does diminish the interest of most drug companies. Humn Pharmaceuticals though wants to ensure people have access to this very proven, safe and effective pain reliever. Go Humn!”