New needs, new drugs
Anesthesiologists use hundreds of different drugs in their work, so it's not surprising they help develop them, too. A big push, says University of Chicago Hospitals anesthesiology chief Jeffrey Apfelbaum, has been to come up with sedatives and painkillers that act rapidly--and clear quickly from the body. In the early 1990s, he says, anesthesiology drugs could remain potent for days, making for groggy patients who recovered more slowly. With the new drugs, he says, "70 percent of our outpatients are able to sit up, stand, and walk away within a few minutes of surgery."
In one of those nice examples of scientific serendipity, the drugs developed for anesthesiology have other helpful uses. Together with other specialists like neurologists and rehabilitation doctors, anesthesiologists staff the University of Chicago Hospitals' outpatient pain clinic. They treat patients with acute pain from surgery and accidents, as well as chronic pain from cancer, back problems, athletic injuries, and migraine headaches.
Pain docs. The anesthesiologists administer carefully tailored combinations of drugs. That includes not just painkillers but also meds that can boost their effectiveness and counteract side effects. "When the surgeon puts a knife in you, it's going to hurt," says Apfelbaum. "We've learned to manage that pain, and now we're applying it to other kinds of pain as well."
The antiserendipitous face of those very same drugs is that some of them make their way through illicit channels to recreational users for an illegal and dangerous thrill. James Zacny, a psycho-pharmacologist in Chicago's anesthesiology department, studies the properties of pain medications like oxycodone (an ingredient in Percocet and OxyContin) that turn useful drugs into drugs of abuse.
Under strict guidelines to protect safety as well as privacy, Zacny uses volunteers with a history of drug experimentation to check their subjective assessment of "drug liking" --which is to say, given the chance, whether they would want to take the drug again. The goal, Zacny says, is to determine the personal and environmental factors that increase the likelihood of pain medication abuse, as well as guiding drug developers in the search for drugs that can kill one kind of pain with less risk of causing another kind. -Tom Hayden
This story appears in the July 12, 2004 print edition of U.S. News & World Report.