Opioids can make pain worse


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Why taking morphine, oxycodone can sometimes make pain worse
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Article By Kelly Servick, May. 30, 2016

“Peter Grace, a neuroscientist at the University of Colorado (CU), Boulder, and his team has been trying to trace hyperalgesia to the way opioids affect the immune system.”

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“There’s an unfortunate irony for people who rely on morphine, oxycodone, and other opioid painkillers: The drug that’s supposed to offer you relief can actually make you more sensitive to pain over time. . . . A new study in rats—the first to look at the interaction between opioids and nerve injury for months after the pain-killing treatment was stopped—paints an especially grim picture. “

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“Animals given opioids become more sensitive to pain, and people already taking opioids before a surgery tend to report more pain afterward.”

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“Grace says the field badly needs a human study that systematically tests pain thresholds over time in opioid users…. In the meantime, he says, “I hope that it’ll get people to really question what the benefit of long-term opioid therapy might be.””

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© 2016 American Association for the Advancement of Science

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11 Responses to “Opioids can make pain worse”

  1. Jon Says:

    While this discovery is possibly a great leap forward in the way painful conditions are treated, it is shameful that due to this discovery doctors are cutting patients off cold turkey after years of high doses and not assisting them in this. A slow reduction in doses along with better therapy and alternative meds should be the standard treatment. Withdrawal from opioids is no small thing, and to do it while you have a painful medical condition makes it nearly fatal, in more ways than one if you get what I mean.

    The medical community has completely changed how they treat patients with proven medical conditions due to changes made by people who are not doctors, don’t have chronic painful maladies. The medical community now treats is as if we are now all “addicts” looking for a fix to get high.

    I found a statement on the DEA’s website stating that the new rules regarding prescribing of narcotic medications should NOT be misinterpreted in a way that patients with established painful conditions be UNDERMEDICATED. The DEA statement actually repeated this again in a one page statement.

    Yet my doctors all took the new rules as a mandate to never prescribe painkillers.

    This new discovery is a half step forward, they need to make alternative painkillers that aren’t going to cause this condition to finish the second half of the full step forward. Meanwhile, there are hundreds of thousands of people who are suffering enormous pain and also getting treated rudely and uncaringly by their doctors.

    • Nancy Sajben MD Says:

      You overlook better alternatives than opioids, consistently posted on this blog for 7 years, all based on strong science. Opioids cause pain. There are better medications. Patients can stick with opioids if they like, but they are creating pain with every dose and never get pain into remission with opioids.

      • Jon Says:

        I’m not aware of these alternatives. I see a pain management specialist that is more like a pill management specialist.
        Is there a place you have where these alternative treatments are listed and instructions on their use?
        I’m an electrical specialist, not medical. I have ruined my body giving every customer my best. I have yet to find a doctor that treats me with even a fraction of the effort I gave.
        My pain management specialist (pms?) usually doesn’t even ener the exam room, he stands in the doorway and writes a refill for 5mg hydrocodone which doesn’t touch the pain. When I asked for something stronger to take, just so I can sleep at night, he shouted at me. I’ve tried three second opinions and they treated me like an addict. It’s humiliating and dehumanizing. And then they bill over a thousand for the initial visit.
        Anyway, is there a link you can direct me to to learn of these other treatments?
        I ask him what else can be done and he says there’s nothing mote he can do since I’ve allready got a scs, which after 18 month has not worked for me. He doesn’t believe me and refuses to try epidurals, anything to get me out of bed and ice packs.
        Enjoy your lights when you get home. Someone damaged their body making it happen.

        • Nancy Sajben MD Says:

          I see only the most challenging, and they have been traumatized by how they’ve been treated.

          I notice one reason doctors get angry is when they are frustrated they have no better tools.

          Even if an electrician charges a lot, he/she is still trying for efficiency doing the best job in limited time, so as not to run up unnecessary cost. We all aim for reasonable speed given skill and responsibility running a giant machine with trillions of parts, some of which can maim or kill you.

      • Jon Says:

        I should add that I am pretty much broke. Because of all the damage to my lumbar area and pain associated with it, I lost a well paying job, ran of savings, went bankrupt, and have sold most of everything I have to cover medical deductibles, and then the rest of associated expenses. I discussed the ketamine nasal spray and he sait it was illegal to administer drugs off label. He was quite upset with me for making that suggestion. I’ve found doctors to be some of the most stubborn people I’ve ever known. No offense.

        • Nancy Sajben MD Says:

          Like talking to a cat.

          • Jon Says:

            I’m sorry? Did I do something wrong?

            • Nancy Sajben MD Says:

              Not you. Did you ever get the feeling talking to a doctor is like talking to a cat.

              My apologies – I am sorry if you thought it was you.

              • Jon Says:

                Thanks for clarifying.
                Where I live the corporation called Greenville Health Systems has bought over 90% of the hospitals, clinics, and private clinics. Then they were all put on a system where they each have a laptop which shows how much time each exam is allotted. The patient’s information is not shown, so the doctors are basically starting from scratch with every visit. There are dozens of entries they have to make so they have their heads down working on the computer the entire visit. They also have an ever increasing quota of patients seen per day. My pms doesn’t know my name and I’ve been seeing him for 4 years now.
                I asked my pcp for a referral and he just shook his head and said I won’t find anyone good in my area.
                I tried to get second opinions before getting the scs implanted and after all the paperwork and records transferred and obligatory urine test the doctors just kicked me out. One got very upset, saying my pms is highly respected, “what the hell are you doing coming here?” Then walked out. His assistant looked so embarrassed.
                His practice charged $1200 for the visit.
                How is it legal for one company to create a monopoly on healthcare?
                Anyway, I periodically stop taking my narcotic painkillers for a week or so every month or two and see if I can handle my pain. I only get so far with physical therapy, ice, heat, TENS unit, and otc meds before I get so bad I have to take something. I don’t tolerate opioids well. If I take more than two 5mg Norco’s I get sick so I am not going to ever become an addict. But I need more than that for breakthrough pain. Right now my remedy is adrenaline. I punch walls, throw stuff, scream obscenities, punch myself in the face or arms, anything to distract me from the hot knife being twisted into my lower back and the phantom pain in my leg (classic sciatica, numb but feels like the knee, hip, and ankle are sprained. ).
                I found your list of things that can help. I’ll do what I’m able to do. Anything needing a doctor to adminiter or prescribe will be impossible.

                • Nancy Sajben MD Says:

                  It’s like this everywhere. Computers since 1990’s more and more turn it over to the AI robots and protocols block any slight deviation.

                  Doctors are not burned out, they are antagonized constantly by robots. Our every urge is to help, but our hands are tied more and more.

                  This chokes out most of the middle class who have any chronic illness, psychiatric or physical.

                  The American medical system has deteriorated progressively rapidly since 1989. We are all prisoners. Your MD kicked you out without even seeing you and charged $1200. Sounds like he has very high overhead because he sees very challenging patients and has x-ray, etc on site. Or, South Carolina charges more than La Jolla.

                  OTOH many MD specialties have had no increase in reimbursement in over 20 years.

                  We are all prisoners, doctors and patients. Most people do not have a choice.

                  Doctors and patients are dehumanized to become perfectly behaved trained AI robots or they get fired or abused or left behind if they can’t keep up the pace.

                  A lot of money went into EHR’s.

                  Now they can deny prescribing an effective antidepressant because I find it works for anxiety and I don’t want my people to take morphine or Xanax when sertraline does perfectly well for many.

                  And the hormone oxytocin works even better, a tiny pill under tongue, your own body makes it.

                  But now they’ve nearly destroyed compounding pharmacies in my area, and are about to destroy all other neighborhood pharmacies because they made a money saving deal to funnel everyone to Walgreens or to I think CVS.

                  Impersonal.

                  Computerized.

                  Robots. They will not need people for this in a year or two. They’re doing the shake down now, and media is writing articles on doctors who deviate.

                  If we cannot Rx antidepressants for anxiety because the robot pharmacy accepts the one and only one FDA approved use, then there goes all the epilepsy drugs we’ve prescribed for pain the last 60 plus years.

            • Nancy Sajben MD Says:

              I did not mean to offend you. I was referring to doctors.

              We would need a bundle of money and at least 3 to 5 years to really prove how much better alternatives are. But even pain specialists turn opioids into religion. I prescribe them, but when patients are willing, read the years of work documented on these pages.


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