Read time: [7-8 min ]
- New research showing why people will develop more pain from taking an opiod
- The science of a pain pill
- Morphine and the immune system
- Giving people drug-less options
- Beyond pain and into function
Reference Article: Why Taking morphine, oxycodone can sometimes make pain worse
Pain pills and pain mills are a major problem in medicine and healthcare. Living and practicing in South Florida for the past 7 years, I’ve had an first hand view at the culture that morphine and oxycodone have created in the practice of medicine and addiction.
Hospitals have had to dramatically alter their treatment of pain patients, and some pharmacies have turned to security. It’s created a culture where people who have serious pain problems are often treated as addicts before getting a prescription. This is a serious problem for people seeking help from cancer treatment, post-surgical care, and major injury who may need help controlling pain.
A recent study shed some more bad news for pain patients last week. The study was presented at the National Academy of Sciences Proceedings and studied pain sensitivity in rats. The scientists compared rats with limb injury and morphine, rats with limb injury and no morphine, and rats with no injury and morphine. The rats that had an injury + morphine had a higher pain sensitivity than all groups.
It took rats with morphine 12 weeks to return to baseline pain sensitivity compared to 6 weeks for the non-morphine control group.
When you have severe pain and you take a drug like oxycodone to get relief, you have hopes that your body will continue to heal during those moments where the pain is lessened. However, this research is showing that the body may become more sensitive to pain afterwards.
When pain becomes prolonged, it creates an environment that sets people up to be hooked on these potent medications.
What happens when you take a pain pill?
It’s not unheard of for a drug to have a side-effect of creating the condition it’s designed to treat.
- Some anti-depressants have been shown to cause suicidal thoughts
- Long term use of headache medication can cause medication overuse headache
There are a couple things that happen.
It was originally thought that opiates like morphine acted on pain tolerance in a similar way as other addictive compounds.
The cell has receptors that act like a lock that only respond to certain keys. A chemical in the brain called dopamine can be released in response to natural compounds like food, and act as a key that opens a reward. When the chemical (key) interacts with the right lock (receptor), then the cell performs a specific action that tells the brain to feel good.
Some drugs like cocaine can flood the brain with keys and turn all of the locks and create a massive reaction in the cell.
That’s why a substance like sugar can make the brain feel good for a moment after a sweet treat, while cocaine produces a high when it floods the brain with chemical stimulation.
In response to this overstimulation, the cell reacts by pulling away locks from the surface to prevent overstimulation. That then leads the cell needing MORE chemical to create the same reaction as the first time.
While that does help to explain feelings of withdrawl and dependence on pain drugs, it doesn’t necessarily explain why people who take morphine become MORE sensitive to pain.
Morphine and Brain Immune Cells
The cells in the brain aren’t strictly neurons or brain cells. Much of the volume of the brain is taken up by cells that help support neurons. One such cell is called microglia which are basically the immune cells of the brain.
If your brain suffers damage or must fight an infection, the microglia are there to clean it up inside the brain.
However, a drug like morphine can cause the microglia to start to act inappropriately. In this case, morphine makes the immune cells release inflammatory chemicals that make your nerves more sensitive to pain. This is called morphine-induced hyperalgesia.
Unfortunately these immune cells don’t just go back to working normally overnight. The study showed that 5 days of morphine caused 12 days of hyper-sensitivity.
People in Pain Need Drug-less Options
Pain is a complicated phenomenon that has to factor in physical tissue damage, social up-bringing, and emotional factors. Only the person in pain can really understand what they are feeling.
This article is not an attack on the use of all pain drugs. There are people that genuinely need these drugs to make living bearable. This includes post-surgical patients, cancer patients, severe wounds, extreme spine pain, deep neuropathic pain, and more. This doesn’t mean that your situation is less significant, but it’s to give you an idea of what the intent of these drugs are for.
If you have pain and it doesn’t fall into those categories, it doesn’t mean that your pain is insignificant, but it may mean that opioids may be inappropriate because there are better options available.
One of the biggest priorities in medicine today is to understand the complexities of pain and to provide options for people that are non-invasive and non-addictive.
Fortunately there has been an explosion of research in the past 20 years that support the use of drug-free interventions that can help control pain from a variety of sources. Some of the therapies supported by evidence include:
- General exercise
- Physical therapy
- Brain stimulation
- Spinal manipulation
Going Beyond Pain and Into Function
When we think about pain reduction as the only outcome goal, we can miss the mark on what is necessary to achieve a successful long-term result.
Shutting off pain without improving the function of the body and correcting the cause of the problem is like pulling the battery out of a fire alarm. The fire alarm isn’t the problem, it’s just doing it’s job. Pulling the battery out of the alarm is only allowing you to ignore the real problem that will cause your house to burn down.
The goal of what I do in the office is to restore the normal structure and function of the human frame, not just to simply find the painful area and make it go away. The good news is that improved overall function of the spine and the nervous system will lead to great results in a large majority of cases. Once people are out of pain, then we can start challenging them and building up their bodies with exercise and strength.