Could Botox Provide an Alternative to Opioids?

By Paul Gaita 09/26/17

A biotechnology company is testing a strategy for pain relief that could make opioid painkillers a thing of the past.

Close up of hands of cosmetologist making botox injection into female lips.

A biotech firm is exploring the possibility that a substance similar to Botox could provide relief to pain sufferers and, in turn, reduce the need for the prescription medication that is at the heart of the opioid epidemic.

According to Quartz, Bonti—a privately held, clinical-stage biotechnology company based in Newport Beach, California—is conducting tests to determine if injections of a pain-relieving neurotoxin similar to Botox could treat pain in a manner that requires no opioids and fewer doses.

The Quartz piece quoted the company's chief executive officer, Fauad Hasan, who says they've met with the Food and Drug Administration (FDA) to expedite the approval process in an attempt to assist with the national opioid epidemic that claimed more than 33,000 lives in 2016 alone.

Bonti's neurotoxin strategy involves the use of a botulinium toxin serotype E, a pain-relieving neurotoxic protein similar to those used in cosmetic procedures and marketed under the brand name Botox. The Bonti neurotoxin is applied in the same manner as Botox, via injection into a muscle that blocks signals from the nerves and prevents it from contracting, which in turn causes the wrinkles in the skin near the muscle to relax and grow soft. 

But the Bonti method would target muscles that have experienced some kind of injury. The neurotoxin would again interrupt signals from neural receptors and cause the muscle to relax, which in turn would stop the muscle spasms produced by the injury that causes pain. The response would appear to be similar to the use of Botox in treating conditions like pain from infrequent migraine and bruxism (teeth grinding).

As Bonti chief medical officer Susan Abushakra noted in Quartz, "You're really giving the muscle the chance to heal and to repair itself."

Bonti CEO Hasan said he expects that his company's treatment will reach the market in about four years, pending approval from the FDA. Pricing also remains an issue to be determined, though Hasan said that single doses of his treatment should be less than that of Botox, which according to the American Society of Plastic Surgeons, on average costs approximately $385.

Another matter that may require address by the company is the possibility of side effects like those that have occurred when Botox is used for pain issues like migraines: patients have reported neck pain, slight or partial facial paralysis, high blood pressure and blurred vision.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.