Why opioids cannot fix chronic pain

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A broken heart is often harder to heal than a broken leg.

In a new paper, researchers say that a broken heart can contribute to lasting chronic pain.

They say that emotional pain and chronic physical pain are bidirectional. Painkillers ultimately make things worse.

The research was conducted by a team at the University of Washington School of Medicine.

Their argument is based on new epidemiological and neuroscientific evidence, which suggests emotional pain activates many of the same limbic brain centers as physical pain.

This is especially true for the most common chronic pain syndromes—back pain, headaches, and fibromyalgia.

Opioids may make patients feel better early on, but over the long term, these drugs cause all kinds of havoc on their well-being.

The researchers said new evidence suggests that the body’s reward system may be more important than tissue damage in the transition from acute to chronic pain.

The system includes the natural release of endorphins from pleasurable activities.

When this reward system is damaged by manufactured opioids, it perpetuates isolation and chronic illness and is a strong risk factor for depression.

Rather than helping the pain for which the opioid was originally sought, persistent opioid use may be chasing the pain in a circular manner, diminishing natural rewards from normal sources of pleasure, and increasing social isolation, according to the team.

The researchers prescribe opioids for their patients and say they have a role in short-term use.

Long-term opioid therapy that lasts months and perhaps years should be a rare occurrence because it does not treat chronic pain well, it impairs human social and emotional function and can lead to opioid dependence or addiction.

What the team recommends is if patients are on high-dose long-term opioids and they are not having clear improvement in pain and function, they need to taper down or switch to buprenorphine.

Two authors of the study are pain experts Mark Sullivan and Jane Ballantyne.

The study is published in the Annals of Family Medicine.

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