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Sunday, January 15, 2012

Avoiding Lasting Pain With Administration of High Dosage Spurts of Morphine

This discovery, in a nutshell, can be found in the last sentence of the abstract:
"Opioids thus not only temporarily dampen pain but may also erase a spinal memory trace of pain."

In other words...
The heretofore uncommon administration of opioids (clinically most often morphine) in high dosage spurts (instead of the standard moderate sustained dosage) has now been shown to have a different effect and distinct advantage.  The moderate sustained amount leaves "memory pain" in the spinal cord.  In chronic pain, pain is sustained after the stimulus is removed.  (a process I didn't know about and which surprised me)  They describe this function on a cellular level elegantly as: "potentiation of signal transmission at the contact points (synapses) between the nerve cells."  Using the high dosage spurt method, pain amplifiers and neural connections become disengaged upon the alleviation of the stimulus.  Chronic pain is thought to be, in cases, caused by or exacerbated by these "memory traces."  With these traces now avoidable, this post-stimulus suffering can be avoided before it even sets in, providing a great advance in anesthesia.

Insightful Random Guy at the Coffeeshop:
"If this becomes a viable treatment for chronic pain, there should be some protocol specifically for people who've been on low-dose opioid treatment for years -- and by 'low-dose' I mean 'low-dose with respect to the individual's tolerance', because low-dose eventually becomes high-dose.  I doubt the short high-dose treatment will also erase the dependence resulting from long-term treatment.

...I wonder how many patients in [this] condition will attempt their own little high-dose experiments."

Found via Science Daily
Image Credit: Vio3b on Flickr

Drdla-Schutting, R., Benrath, J., Wunderbaldinger, G., & Sandkuhler, J. (2012). Erasure of a Spinal Memory Trace of Pain by a Brief, High-Dose Opioid Administration Science, 335 (6065), 235-238 DOI: 10.1126/science.1211726
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1 comment:

  1. That's a fascinating finding, though it would be especially interesting to hear how medical services would manage it, as it sounds like a potentially dangerous pathway into addiction.


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