Brew-Cast #1: Do Opioids Cause Chronic Pain?


Author: Don Stader M.D

Educational Pearls: 

  • Don speaks with University of Colorado Dr. Peter Grace, a pain researcher. His paper: “Morphine paradoxically prolongs neuropathic pain in rats by amplifying spinal NLRP3 inflammasone activation” – suggests that morphine increases / causes chronic pain
  • In this study rats were given nerve injuries – a group was given morphine to treat the pain. the other no morphine. The rats receiving morphine had significant negative effects – with longer duration of pain and hypersensitization! In papers words – “This study predicts that prolonged pain is an unrealized and clinically concerning consequence of the abundant use of opioids in chronic pain:”
  • Interestingly – opioids seems to cause immunosupression in the peripheral nervous system and blood stream, but in the spinal cord cause inflammation. This changes spinal cord physiology and makes nerves hypersensitive to pain
  • Interesting – and from some of Peters’ other studies – exercise both before an after nerve injury can reduce pain and how rats interpret pain can be transferred from rat to rat by transferring spleen cells.
  • In other studies – IL-10 (an anti-inflammatory immuno-modulator) has been injected into rats and dog joints – and helps reduce pain from arthritis and other injuries.
  • Peter & other pain researchers foresee a world where we treat the underlying inflammation and pathophysiologic changes that cause pain – rather than trying to mask it with potentially dangerous agents such as opioids.
  • This is yet another reason to exercise caution with opioids – they are bad Ju-Ju!!

Link to Podcast:

References: A direct link to Peter’s article!

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