how a scottish woman can help us stop the opioid crisis

A woman who inherited a rare genetic mutation is giving doctors and scientists an unprecedented glimpse in how we process pain, fear, and anxiety, and how we could treat all three.

It turns out that Wolverine is real, and he's a 71 year old Scottish woman named Jo Cameron who doesn't feel pain, fear, or anxiety, and quickly bounces back from injuries and surgeries with very few scars. What's her secret? Her genome contains a copy of a gene called FAAH-OUT without its leading nucleobases, which she appears to have inherited from her father and partially passed on to her son, whose birth she barely even felt. For all intents and purposes, she's a very happy woman living a full life with her only complaint being a little scatterbrained, a side effect of the mutated FAAH enzyme affecting short term memory.

Interestingly enough, the enzyme in question works in the endocannabinoid system, the same one targeted by medical cannabis researchers, and this discovery shows us how some of the active ingredients in pot can soothe the symptoms of PTSD.Of course, this doesn't necessarily validate the use of medical marijuana as a cure-all when it comes to pain and anxiety since the enzyme in question is a far cry from THC and its derivatives despite similar targets in the brain and side-effects. But it does show us potential new ways to replace opioids to deal with severe pain and control anxiety with the same drug.

Instead of deploying medication originally meant to help terminally ill patients in pain get their affairs in order to treat trauma and degenerative soft tissue damage, we could simply shut off the pain. With no euphoria or compounds that promote physical dependency, it's unlikely that patients would become addicted to it, build up a tolerance, then seek cheaper and more potent and illegal alternatives like heroin should they lose their source of prescriptions and pills. They might have some problems remembering where they left their keys or why they just came into a room for a few weeks as their bodies heal, but that seems like a small price to pay for safer and more effective pain management.

In an ideal world, we could use a synthetic version of the mutated FAAH enzyme for medical procedures as well, using general anesthesia more sparingly to avoid potential complications while dulling patients' anxiety about pressure or discomfort they might feel, as well as the effects of a paralytic agent that would be necessary to prevent reflexive movement during a surgery. So, in a way, the key to combating the opioid epidemic tearing its way through the United States and Canada is a rare mutation in the genome of a Scottish senior citizen, and now that we've found it, we just need to find the right way to use it.

See: Habib, M. A., (2019) Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity, BJA, DOI: 10.1016/j.bja.2019.02.019