Reduced Cold Pain Tolerance in Chronic Pain Patients Following Opioid Detoxification – free full text PubMed article
The results of this study are obvious to those of us with pain, but not to scientists, exposing how differently our pain is viewed from the outside.
One potential consequence of chronic opioid analgesic administration is a paradoxical increase of pain sensitivity over time. Little scientific attention has been given to how cessation of opioid medication affects the hyperalgesic state. In this study, we examined the effects of opioid tapering on pain sensitivity in chronic pain patients.
Twelve chronic pain patients on long-term opioid analgesic treatment were observed in a 7- to 14-day inpatient pain rehabilitation program, with cold pain tolerance assessed at admission and discharge. The majority of participants were completely withdrawn from their opioids during their stay.
We hypothesized that those patients with the greatest reduction in daily opioid use would show the greatest increases in pain tolerance, as assessed by a cold pressor task.
A linear regression revealed that the amount of opioid medication withdrawn was a significant predictor of pain tolerance changes, but not in the direction hypothesized. Greater opioid reduction was associated with decreased pain tolerance. This reduction of pain tolerance was not associated with opioid withdrawal symptoms or changes in general pain.
These findings suggest that the withdrawal of opioids in a chronic pain sample leads to an acute increase in pain sensitivity.
It seems strange that the researchers could have expected any other result. That can be explained by the disbelief our claims of pain encounter in the scientific community. They don’t take our word for the seriousness of our pain and seem to believe the opiates we take are ineffective.