Scientists have long recognized a link between opioid use disorder (OUD) and chronic pain, but the brain processes behind this connection remain unclear.
Researchers at The Ohio State University have uncovered one possible explanation: central sensitization, a condition where the brain and spinal cord process pain signals abnormally.
The study, published in PAIN Reports and led by Dr. O. Trent Hall, sheds light on how central sensitization could play a role in the challenges faced by individuals with OUD and chronic pain. Central sensitization refers to an exaggerated pain response in the nervous system.
In people with this condition, the spinal cord becomes highly efficient at sending pain signals to the brain, while the brain struggles to shut those signals down. This imbalance causes them to experience more intense and persistent pain compared to others.
The study involved 141 participants from the addiction treatment center at Ohio State Wexner Medical Center in Columbus, Ohio.
Researchers asked participants questions about their pain levels, how pain affected their daily lives, their beliefs about pain, and their expectations for pain and addiction treatment.
The goal was to explore how central sensitization might influence their experiences with both pain and opioid addiction.
One major finding was that individuals with greater central sensitization reported a lower quality of life. Many of these participants also revealed that pain played a significant role in the development and continuation of their opioid addiction.
They described using opioids initially to manage pain, delaying addiction treatment out of fear of pain, and even increasing opioid use due to worsening pain. Fear of pain was also a common reason they gave for worrying about a relapse in the future.
The researchers noted that central sensitization might make it more difficult for individuals with chronic pain and OUD to quit opioids compared to those with OUD alone.
This is because their heightened pain response may drive a stronger reliance on opioids for relief. Chronic pain not only makes recovery harder but also creates additional barriers to seeking and staying in treatment.
The findings suggest that central sensitization could be a key factor complicating the treatment of OUD in people with chronic pain. Measuring and addressing central sensitization in these patients might help clinicians develop better treatments tailored to their unique challenges.
For example, therapies targeting central sensitization could reduce pain sensitivity and improve outcomes for individuals struggling with both chronic pain and OUD.
This study highlights the need for a deeper understanding of the brain's role in chronic pain and opioid addiction. By exploring conditions like central sensitization, researchers and clinicians can pave the way for more effective strategies to help those suffering from this difficult combination.
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