Blunting pain’s emotional component

Blunting pain’s emotional component | Newswise: News for Journalists – Mar 2019

Chronic pain involves more than just hurting. People suffering from pain often experience sadness, depression, and lethargy.

These days, I’m almost surprised they’re not claiming that people are causing their own pain when they experience “sadness, depression, and lethargy”.

That’s one reason opioids can be so addictive — they not only dampen the pain but also make people feel euphoric. [not!]

Wrong. Those of us using opioids for serious pain do not experience this euphoria; see Opioids + Pain != Euphoria for an explanation why this doesn’t happen.   

Researchers at Washington University School of Medicine in St. Louis have shown they can block receptors in the brain responsible for the emotional components of pain and restore the animal’s motivation.

That’s what I really want and need: a medication to restore all the motivation I lose from facing pain that arises from so many activities.

Their findings could lay the groundwork for developing new, less addictive approaches to pain treatment.

Why not provide this medicine to people with anxiety and depression too?

Since it’s fashionable to assume that some emotional discomfort is at the root of our chronic pain, such a drug would free a patient who is catastrophizing, wouldn’t it?

“By targeting the emotional aspects of pain, we hope to make pain less debilitating so that patients won’t crave the emotional high they get from opioids.”

I’m insulted by this common erroneous assumption that we crave the “emotional high” from our pain medication. Getting pain relief is always a pleasure in itself, but far from the euphoria we see described by addicted people.

All these pain researchers really need to experience some of their own pain and then relief from opioids before assuming they know why we “crave” our opioids.

Opioid painkillers, such as morphine, oxycodone and fentanyl, target receptors on brain cells called mu opioid receptors. In contrast, the Washington University researchers studied kappa opioid receptors, which operate very differently.

Activating the kappa receptor makes people feel depressed, sad and unmotivated.

Some of the rats in the study had been injected in a paw with a substance that causes persistent inflammation. To measure the emotional effects of that pain, the researchers used a rewarding task in which the animals could work for sugar as a way to measure motivation. After being taught to push a lever to get sugar, most rats will keep pushing. In these experiments, the animals had to push the lever progressively more each time they wanted a pellet of sucrose.

When the animals experienced pain, they were less motivated to work to obtain the reward,” said first author Nicolas Massaly, PhD, an instructor in anesthesiology.

“It’s often the same for people in pain who don’t get as much pleasure from daily activities they usually enjoy.

That’s certainly an odd way to state it.

People in pain not only don’t enjoy their regular activities, but they also don’t enjoy *any* activity (and even life itself) because we are in pain. What is it about real-life pain that these researchers cannot understand?

Everybody knows how unpleasant pain is just by itself. Yet, these researchers seem to think it is only unpleasant because it has referred effects like side effects. 

They completely ignore the main effect of bodily pain which has evolved to create the most extreme unpleasant “sensation” an organism can experience, so extreme that an organism will exhaust every last bit of its energy to escape it, which is exactly why torture is so effective.

But when the rats with inflamed paws were treated with a compound to block kappa opioid receptors in their brains, the animals recovered the motivation to obtain the sugar, and pushed the lever as often as those who did not have inflamed paws.

They were able to demonstrate that when rats were in pain, their kappa opioid receptors were very active in a part of the brain — the nucleus accumbens — linked to emotion.

The researchers dampened this kappa opioid receptor activity by blocking the release of a natural stimulator of kappa opioid receptors called dynorphin — which is produced in the brain and is kind of like the inverse of the endorphins released by activities such as exercise.

The researchers don’t seem to understand that when we have chronic pain we still push ourselves to exercise, but it’s far more painful than lying still.

For chronic pain patients exercise does not make them feel better; it makes them feel worse. This is what makes it so hard to follow an exercise program in order to get the long-term benefits of exercise: the immediate result is just more pain.

“By blocking dynorphin release, we were able to restore motivation in the animals despite the fact that we did not completely eliminate their pain,” Massaly said.

I would be very curious to try a drug like this, one that blunted my emotional response to pain without affecting the physical response of my body. This would be like passing a kidney stone while just going about your daily business and ignoring it.

I really cannot imagine what that would be like. The scenario would go like this: you stub your toe and it hurts terribly as usual but you don’t care, so you might kick that stone over and over and over again because there is no emotional component of being attracted to or repulsed by the pain that you suffer. Really?

2 thoughts on “Blunting pain’s emotional component

  1. Kathy C

    Now we can brace ourselves for another round of “thoughtful” news articles, written by journalists with no background in science and no experience of pain, denying the existence of pain. This is deliberate, they do not want the public aware that pain can exist. The insurance and hospital industries will support these alternative reality theories, and fund more research in this area.

    In the meantime another state endorses pseudo science, https://sciencebasedmedicine.org/new-florida-law-forces-physicians-to-endorse-pseudoscience/ My state already did this, and our DOH actually lists a chiropractor on their site, under chronic pain. The suicide rate and overdose rates are continuing to climb, even though they are promoting alternative medicine. Our local acupuncturist is closing up shop, even the the VA will pay for acupuncture, no one is seeking out here services. Her parking lot is always empty. She put up campaign signs, showing us here true allegiances, and people around here don’t forget. Maybe it is a coincidence that she is moving to Florida.

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  2. Kathy C

    Zyp,

    I came across this on Huffington Post, https://www.huffpost.com/entry/disability-and-therapy_n_5d669052e4b01fcc690d2856 There is a theme here, since many “therapists’ doubt the existence of pain, and are taught that people can be talked out of it.

    I no longer engage in “therapy” and many people I know with chronic pain now avoid any kind of therapy. It is not unusual that therapists continue to make their clients describe their pain at every appointment, each time they are looking for the “emotional response” or “catastrophization” that Beth Darnell’s highly publicized work, claims is the cause of chronic pain. If you look at the most popular and mainstream psychology articles about pain or chronic pain, each one makes unsubstantiated claims about “catastrophization,” Depression and emotional components of pain. Therapists are denying the existence of pain or ascribing various motivations to it. It is terrifying that anyone seeking therapy is exposed to this kind of abject denial, and it is a form of abuse.

    There is something a lot bigger going on here, on the scale of brainwashing. Psychological torture to protect the profits of the insurance industry?

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