Delivery from discomfort

Even when these drugs work, they come with a host of problems, including addiction, side effects such as constipation, nausea and itchiness, and the risk of overdose - all of which are made more likely because some people experience such severe chronic pain that they require massive doses of opioids simply to function. The vaso-occlusive crises are one likely cause of that damage, Gupta says, but outside those crises, the oxidative stress, inflammation and ruptured red blood cells associated with sickle-cell disease could also cause injury to neurons. The opioid conundrum Looking across the treatment landscape for pain in sickle-cell disease, one group of drugs dominates: opioids. "The typical dilemma that an emergency-room doctor faces," Roberts says, "is am I treating this patient with opioid because they're having pain and I'm going make the pain better, or are they pulling the wool over my eyes and they're really just drug-seeking?" This is especially problematic given the high doses of opioids that many people with sickle-cell disease need to manage their pain.