Summary: Doctors are more likely to prescribe opioids to those living with chronic pain. Thus, these are also people more likely to develop OUD. A new study shows that these are individuals living with a peculiar kind of problem called central sensitization. Such individuals are more likely to suffer from chronic pain and respond poorly to pain treatment, and thus at a greater risk of OUD. It is no secret that those living with chronic pain are more likely to be prescribed opioids, and thus such people are also more likely to develop pain medication addiction. However, the relationship between OUD and chronic pain is as casual as it may sound.
There are many people for whom doctors prescribe opioids for their chronic pain, and yet only some develop OUD. Therefore, there is a need to understand the link between the two. Researchers could identify one potential mechanism in one of the first of its kind of study. They found increased central sensitization among those living with OUD. Central sensitization is a unique issue affecting many chronic pain patients. In this condition, individuals have a spinal cord that is exceptionally good at sending pain signals to the brain. Consequently, their brain struggles to overcome these pain signals and becomes sensitized. Hence, such people are more likely to suffer from pain and have a low pain threshold.
In the first of its kind of study, researchers used a special scale to measure central sensitization in those living with OUD. It is the first study to demonstrate that those living with OUD or opioid addiction have central sensitization. This latest study was published in the journal Pain Reports. In the study, researchers enrolled 141 patients living with OUD and being treated for opioid addiction. In the study, they had to answer questions regarding their pain, quality of life, pain beliefs, and more. These questions helped researchers understand central sensitization in such patients.
People living with chronic pain are more likely to be living with OUD. At the same time, those living with chronic pain also have difficulty living without opioids. Thus, they are at significant risk of developing opiate dependence and living with OUD. In addition, researchers found that those living with OUD had worse quality of life, more difficulty controlling chronic pain, and greater central sensitization. People living with central sensitization were more likely to seek pain treatment and prescribed opioids for their pain. Unfortunately, this is often the beginning of opioid addiction for many such individuals. Moreover, in these people, pain is more likely to persist for a long time and have treatment relapses, which further adds to opioid dependence risk.
Therefore, researchers say that central sensitization may significantly complicate OUD treatment. However, it also means that clinicians should measure central sensitization in those living with opioid addiction to treat OUD successfully.One of the issues why this problem often remains neglected is that very few physicians specialize in pain and addiction treatment. Hence, most patients continue to receive treatment for these conditions separately. Nevertheless, there are some specialists in the US that specialize both in pain and opioid addiction treatment. However, health experts warn that, at present, there are very few treatment options for those living with central sensitization and OUD. It means that doctors need to explore different treatment approaches in those living with OUD, including non-pharmacological means.
Addictionology center in St Louis provides a holistic set of services to treat chronic pain as well as medication for opioid use disorder. It has its telemedicine addiction treatment program along with suboxone treatment to provide you with the facilities in the comfort of your home.
By Gurpreet Singh Padda, MD, MBA, MHP