Opioids and abnormal pain perception: New evidence from a study of chronic opioid addicts and healthy subjects.
Recent evidence reported on increased pain sensitivity in animals following parenteral opioid administration and in humans subsequent to intravenously of short-acting opioids and possibly in drug addicts. The aims of the present study were to explore the possibilities that (1) pain perception is altered in chronic opioid addicts (OAs); (2) if indeed so, the cessation of opioid consumption resets their altered pain perception. Sixty heroin or methadone OAs who attended a 4-week inpatient detoxification program were exposed to the cold pressor test (CPT) upon entrance to the program, at 7 and 28 days subsequent to the cessation of opioid consumption (verified by repeated urine toxicology tests). Latency of pain onset (s), pain intensity (0-100 VAS), and tolerance (time for hand withdrawal) in response to the CPT were measured. In comparison with 70 healthy controls, the OAs demonstrated prolonged latency (6.6+/-3.5s versus 10.9+/-7.7s; p < 0.0001); decreased VAS (74+/-16 versus 55+/-20; p < 0.0001); shorter tolerance (56.4+/-51.3s versus 31.7+/-40.7s; p = 0.001). No differences between the three time points in any of the three measures were detected in the OAs. The results provide further evidence of opioid-induced hyperalgesia in the OA population, as manifested by their quicker hand withdrawal. In addition, it appears that detoxification from opioids does not reset pain perception for at least 1 month.
Pud
Dorit
D
Faculty of Social Welfare and Health Studies, University of Haifa, Israel; Haifa Pain Research Group, Israel.
Cohen
Doron
D
Lawental
Eli
E
Eisenberg
Elon
E
D002908:Chronic Disease; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation* / Q000652:urine; D010146:Pain / Q000523:psychology*; D010465:Perception; D011930:Reaction Time; D012016:Reference Values; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology / Q000523:psychology