PAIN MEDICATION THAT CAN BE INHALED

A study published last week in The Journal of the American Medical
Association found that many elderly people who are in pain do not receive
adequate medication to ease their discomfort. But this problem is not
limited to the elderly. Other reports in recent years have drawn attention
to the fact that many cancer patients, as well as people recovering from
surgery, do not get enough pain relief either.

Aradigm Corp. has patented a technology that it says will make pain
medication much easier to administer.

The company, which is based in Hayward, Calif., specializes in making
inhalable forms of drugs that previously have had to be injected --
insulin, for example. It is also developing an inhalable form of morphine,
which is often the drug of choice for those in severe pain but which must
be administered intravenously.

Dr. Reid Rubsamen, vice president of medical affairs for Aradigm, first
started thinking about low technology ways to improve the lives of patients
while he was pursuing a doctorate at the Massachusetts Institute of
Technology. He is the inventor or co-inventor of 33 patents held by
Aradigm, including the pain-relief technology, which is in clinical trials.
"Currently, IV pumps are underutilized in the home," said Rubsamen, an
anesthesiologist. "You have to pay for a nurse to administer the pump and
it gets very expensive."

He added, "The whole idea is to liberate patients from IV pumps and to give
them good access to effective pain relief."

Aradigm is developing a hand-held electronic inhaler that holds 30 doses of
morphine sulfate. The inhaler is programmed so that a patient can receive a
new dose only at prescribed intervals.

This easy access to morphine, however, presents a new problem: How to keep
the drug out of the hands of people who should not have it. Rubsamen has
also patented a system similar to that found in so-called smart guns. The
inhaler will work only once it has read a digital code on a bracelet worn
by the patient.

This precaution will keep the inhaler out of the hands of children, but it
is unlikely to thwart an adult in the household who wanted to procure the
morphine for recreational reasons.

"If you're a felon, you can defeat the system by stealing the bracelet,"
Rubsamen acknowledged. "But in real life, the main safety issue is someone
picking it up accidentally.' Aradigm is developing the pain-management
system in partnership with SmithKline Beecham. The patent, number
5,694,919, is the most recent to be assigned to Aradigm for the safety
technology.

Drug Testing By a Machine Although drug testing is becoming increasingly
prevalent in the workplace, blood and urine tests can detect only a handful
of the many mind-altering substances available either legally or illegally.

Thus a process called drug recognition -- first developed by the Los
Angeles Police Department in 1979 -- is becoming more widely used. Officers
trained in drug recognition look for behavioral and physical signs that are
characteristic of drug use.

Scott Alpert, a drug test administrator at the University of Maryland at
College Park, has patented a software system that he says enables a machine
to do what these trained officers do.

Alpert contends that his system can detect drug use -- and identify which
class or classes of drugs a person has been using -- simply by empirically
evaluating that person's eyes.

His device measures pupil size, tracks eye movement and gauges the eyes'
reaction to light. Someone who has ingested hallucinogens like LSD or
certain mushrooms will have hugely dilated pupils, for example. "Whereas
for opiates a big sign is that pupils will be constricted and won't react
to light," Alpert said.

Currently, it takes Alpert's invention about six minutes to evaluate
someone. "But I'm hoping to get that down to 30 seconds," he said. Alpert,
who said his system was being tested by several police departments, has
started Drugensic, a company based in Ellicott City, Md., to develop the
product.

Checked-by: (Joel W. Johnson)