Chronic pain treatments can be dangerous and ineffective. These Pitt researchers are working on a solution.

Every year, nearly 100,000 people in the United States die from overdoses, and many of these deaths are related to opioids.

"To put it into perspective, that's two Heinz Field's worth of people who die every year from opioid overdoses," said Trent Emerick, associate professor in the departments of anesthesiology, perioperative medicine and bioengineering. Along with appointments in the School of Medicine and Swanson School of Engineering, he directs Pitt's Pain Medicine Fellowship Program.

Emerick has a host of tools at his disposal when it comes to treating pain, but some of the most effective - and most intrusive - methods come with a host of side effects and potential complications.

"I wanted to develop something a little longer lasting than a nerve block, but not something as risky as the permanent implants that have a lot of risks and side effects," Emerick said. With the help of two Swanson School of Engineering researchers, he came up with a solution: "a bioabsorbable, or biodegradable, nerve stimulator."

The invention has earned the researchers multiple internal grants, which yielded enough preliminary research to secure National Institutes of Health funding. The team earned a Helping End Addiction Long term (HEAL) grant as well as a Small Business Technology Transfer (STTR) award, which required the team to start a company so they could bring their final product to market.

"We call it Vanish Therapeutics Inc. because [the stimulator] dissolves in the body."

Finding what works for persistent pain

When pain persists for three months, it's classified as chronic. At that point, "The spinal cord and brain can become overactivated and the pain itself starts to take on a life of its own outside of the original site of tissue injury," Emerick said. As the pain worsens, many of patients are ultimately seen by physicians in primary care, surgery or pain management specialties. But these pain syndromes can be difficult to treat, and while doctors prescribe opioids to help, the drugs are often not effective and present significant side effects, including tolerance, dependence, misuse and opioid use disorder.

Extreme options like implanted devices tend to work extremely well, Emerick said, but even if they eliminate the pain, they're problematic.

"If the pain gets better, now the device is stuck in the body. If it gets infected, it has to be removed," he said. It's a risky, not to mention expensive procedure. In some cases, implanted devices can even lead to more pain. "The overall complication rate with all of these risks combined is 30%-40%."

But the nerve stimulator not only dissolves in the body as pain improves over a predetermined period of time, but if for any reason a person is unhappy with it, the battery can be adjusted to emit a specific waveform that will quickly break down the stimulator: "degradation on command," according to Emerick.