Abstract
Objective: One potential consequence of chronic opioid analgesic administration is a paradoxical increase of pain sensitivity over time. Little scientific attention has been given to how cessation of opioid medication affects the hyperalgesic state. In this study, we examined the effects of opioid tapering on pain sensitivity in chronic pain patients. Design: Twelve chronic pain patients on long-term opioid analgesic treatment were observed in a 7- to 14-day inpatient pain rehabilitation program, with cold pain tolerance assessed at admission and discharge. The majority of participants were completely withdrawn from their opioids during their stay. Outcome Measures: We hypothesized that those patients with the greatest reduction in daily opioid use would show the greatest increases in pain tolerance, as assessed by a cold pressor task. Results: A linear regression revealed that the amount of opioid medication withdrawn was a significant predictor of pain tolerance changes, but not in the direction hypothesized. Greater opioid reduction was associated with decreased pain tolerance. This reduction of pain tolerance was not associated with opioid withdrawal symptoms or changes in general pain. Conclusions. These findings suggest that the withdrawal of opioids in a chronic pain sample leads to an acute increase in pain sensitivity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1158-1163 |
| Number of pages | 6 |
| Journal | Pain Medicine |
| Volume | 9 |
| Issue number | 8 |
| DOIs | |
| State | Published - Dec 3 2008 |
| Externally published | Yes |
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Keywords
- Chronic pain
- Cold pressor task
- Hyperalgesia
- Opioids
- Taper
ASJC Scopus subject areas
- Clinical Neurology
- Anesthesiology and Pain Medicine
Cite this
Reduced cold pain tolerance in chronic pain patients following opioid detoxification. / Younger, Jarred; Barelka, Peter; Carroll, Ian; Kaplan, Kim; Chu, Larry; Prasad, Ravi; Gaeta, Ray; Mackey, Sean.
In: Pain Medicine, Vol. 9, No. 8, 03.12.2008, p. 1158-1163.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reduced cold pain tolerance in chronic pain patients following opioid detoxification
AU - Younger, Jarred
AU - Barelka, Peter
AU - Carroll, Ian
AU - Kaplan, Kim
AU - Chu, Larry
AU - Prasad, Ravi
AU - Gaeta, Ray
AU - Mackey, Sean
PY - 2008/12/3
Y1 - 2008/12/3
N2 - Objective: One potential consequence of chronic opioid analgesic administration is a paradoxical increase of pain sensitivity over time. Little scientific attention has been given to how cessation of opioid medication affects the hyperalgesic state. In this study, we examined the effects of opioid tapering on pain sensitivity in chronic pain patients. Design: Twelve chronic pain patients on long-term opioid analgesic treatment were observed in a 7- to 14-day inpatient pain rehabilitation program, with cold pain tolerance assessed at admission and discharge. The majority of participants were completely withdrawn from their opioids during their stay. Outcome Measures: We hypothesized that those patients with the greatest reduction in daily opioid use would show the greatest increases in pain tolerance, as assessed by a cold pressor task. Results: A linear regression revealed that the amount of opioid medication withdrawn was a significant predictor of pain tolerance changes, but not in the direction hypothesized. Greater opioid reduction was associated with decreased pain tolerance. This reduction of pain tolerance was not associated with opioid withdrawal symptoms or changes in general pain. Conclusions. These findings suggest that the withdrawal of opioids in a chronic pain sample leads to an acute increase in pain sensitivity.
AB - Objective: One potential consequence of chronic opioid analgesic administration is a paradoxical increase of pain sensitivity over time. Little scientific attention has been given to how cessation of opioid medication affects the hyperalgesic state. In this study, we examined the effects of opioid tapering on pain sensitivity in chronic pain patients. Design: Twelve chronic pain patients on long-term opioid analgesic treatment were observed in a 7- to 14-day inpatient pain rehabilitation program, with cold pain tolerance assessed at admission and discharge. The majority of participants were completely withdrawn from their opioids during their stay. Outcome Measures: We hypothesized that those patients with the greatest reduction in daily opioid use would show the greatest increases in pain tolerance, as assessed by a cold pressor task. Results: A linear regression revealed that the amount of opioid medication withdrawn was a significant predictor of pain tolerance changes, but not in the direction hypothesized. Greater opioid reduction was associated with decreased pain tolerance. This reduction of pain tolerance was not associated with opioid withdrawal symptoms or changes in general pain. Conclusions. These findings suggest that the withdrawal of opioids in a chronic pain sample leads to an acute increase in pain sensitivity.
KW - Chronic pain
KW - Cold pressor task
KW - Hyperalgesia
KW - Opioids
KW - Taper
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UR - http://www.scopus.com/inward/citedby.url?scp=56849088619&partnerID=8YFLogxK
U2 - 10.1111/j.1526-4637.2008.00475.x
DO - 10.1111/j.1526-4637.2008.00475.x
M3 - Article
C2 - 18564998
AN - SCOPUS:56849088619
VL - 9
SP - 1158
EP - 1163
JO - Pain Medicine
JF - Pain Medicine
SN - 1526-2375
IS - 8
ER -