Scientists explored the connection of brain mechanisms to opioid use disorder and chronic pain. They classified the mechanism as the "central sensitization."
The study was considered the first of its kind. It was participated by scientists from The Ohio State University Wexner Medical Center and College of Medicine and University of Michigan Medical School.
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Relationship Among Opioid Disorder, Chronic Pain and Central Sensitization
People with opioid use disorder and chronic pain struggle more to stop using opioids than those who only have the disease. The study could clarify these relationships to see how the two factors were connected in the brain.
According to O. Trent Hall, lead author of the research, the study is the first to provide a scale that evaluates central sensitization to patients with opioid use disorder. It also revealed a new technique for easily evaluating central sensitization among persons with opioid use disorder and provides the first evidence of central sensitization underpinning the chronic pain and OUD link.
Central sensitization describes the abnormal pain processing in a person's brain and spinal cord. People with central sensitization find it difficult to block pain impulses once they have entered their brains. People who experience it have spinal cords unusually good at transmitting pain signals to the brain. It suggests that those with more central sensitization feel pain more strongly than others.
One hundred forty-one people from Ohio State Wexner Medical Center's addiction treatment center participated in the study. The researchers used the American College of Rheumatology 2011 Fibromyalgia Survey Criteria to ask the participants. It was given out through an electronic survey. The researchers asked the participants to respond to questions like quality of life and pain interference. They also asked about the participants' pain beliefs and expectations of pain and addiction treatment.
In terms of quality of life, the participants were asked about the eight life domains: general health, mental health, physical functioning, social functioning, bodily pain, vitality, and role limitations (due to physical health and emotional problems).
Hall discovered that patients with opioid use disorders had lower quality of life when their central sensitization was higher.
"Additionally, patients higher in central sensitization were more likely to report pain as a major reason for why their opioid addiction first began, as well as for putting off addiction treatment, continuing and increasing their use of opioids, and fear of pain causing OUD relapse in the future," senior author Daniel J. Clauw said.
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Opioid Research Further Study
The team intends to follow patients with central sensitization and opioid use disorder over time to see if they respond to treatments differently or experience different results. They also plan to investigate whether currently available treatments for central sensitization are helpful for patients with opioid use disorder and chronic pain.
The Ohio Department of Medicaid's Care Innovation and Community Improvement Plan provided the funding. In state lawsuits against opioid producers for their part in the opioid overdose crisis, Clauw has provided testimony. The other authors state that they have no pertinent conflicts of interest.
The study titled "Central sensitization in opioid use disorder: a novel application of the American College of Rheumatology Fibromyalgia Survey Criteria" was published in the journal PAIN Reports.
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