Anthrax: Lethal Bacteria or Miracle Drug?

Illustrated by Sophia Li

On Sept. 18, 2001 – one week after the attacks of 9/11 – a series of letters were mailed to U..S government officials that read “Death to America. Death to Israel. Allah is Great.” Laced with lethal doses of anthrax, these letters were designed to kill the reader upon being opened. Five officials tragically lost their lives to this ruse and seventeen more were injured, making these letters “the worst biological attacks in U.S. history” according to the FBI [3]. Since then, Bacillus anthracis, the anthrax-causing bacteria, has had an awful reputation. The gruesome skin lesions, painful swallowing, and swollen neck glands the bacteria’s spores cause almost demand revulsion [1]. But now, researchers at Harvard medical school are reversing that narrative by exploring the possibilities of using the anthrax-causing bacteria as an alternative pain medication. 

Anyone who has walked through the pharmacy aisles of a supermarket can attest to the sheer number of pain medications that range in size, shape, color, price and level of relief. Filtering for high-relief pain medication, however, there are only two main groups: anesthetics and opiates. Both these forms of pain medication come with serious drawbacks that make anthrax, despite its less-than-ideal reputation, seem like a reasonable option. Statistics published by the American Society of Medicine reveal that of 276,000 adolescents that used opiates, 122,000 (a staggering 44%) had a prescription and were addicted [5]. Even when prescribed in low doses with a regimented schedule by a physician, opiates have a high risk for addiction. As such, there are strict restrictions placed on when they are used, but such restrictions also prevent people who experience severe pain from having access to adequate relief. 

Anesthetics, the other option for patients suffering from extreme pain, unfortunately, don’t fare much better. Although they are not as addictive as opiates, anesthetics can have a host of side effects including nausea, muscle aches, sore throat and hypothermia. Furthermore, anesthesia can alter one’s breathing, heart rate and blood pressure, so one small deviation from the prescription could send a patient into a coma or worse [2]. These widespread effects stem from anesthesia’s ability to restrict nerves from signaling to the brain and body, which is why an entire medical specialty is dedicated to monitoring the type and amount of anesthesia given to a patient. Even if anesthesia is used correctly and doesn’t elicit any side effects, it runs from $300 to $1000 per hour [7]. For patients with chronic pain, anesthesia would be an outrageous expense on the scale of millions of dollars a year. Additionally, patients suffering from any sort of internal pain wouldn’t feel relief from a topical anesthetic – an ointment or solution that numbs an exterior region of the body [4]. Their only other option is an inhalational anesthetic, which typically leaves the patient unconscious. Overall, the cost, side effects and unconsciousness that come with anesthesia restrict its use outside hospital settings as a long-term solution. 

Bacillus anthracis presents an alternative to the adverse effects and cost of opiates and anesthetics. Harvard medical school professor Isaac Chiu pioneered the research of anthrax for pain relief, publishing his study on anthrax pain regulation in December 2021. He explains that bacterial toxins like anthrax “represent a new way to target pain mediating neurons” [6]. The side effects of anesthesia and opiates stem from an inability for targeted application. Anesthesia silences neurons other than those responsible for pain, and opiates alter neurochemical activity to elicit feelings of pleasure throughout the brain. Bacillus anthracis’ precise targeting presents a way to minimize these effects. When experimenting with mice, Chiu and his team found that the animals could not sense pain from mechanical stimuli such as pinpricks and hot plates when injected with anthrax, while heart rate and other bodily functions remained the same [8]. This seemingly beneficial behavior of anthrax begs the question: Why would a deadly bacteria evolve to suppress the pain of its host? One possibility is that in silencing the host’s pain receptors, Bacillus anthracis is able to prevent triggering an immune response, which explains why anthrax skin lesions are painless [6]. 

Regardless of how effective anthrax may be in suppressing pain, there is likely still a long way before human trials can be conducted. But perhaps if we get over our initial aversion towards the bacteria, the field of medicine can advance into a new, more pain-free era. 

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