Most People Don’t Feel Euphoric From Opioids

Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science –  By Nicoletta Lanese – Oct 2019

Opioids are known to spark feelings of euphoria in users, but does everyone really share the same experience?

Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think

But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it. In fact, people who are not addicted to opioids may feel subjectively worse after taking the drug, according to cognitive neuroscientist Siri Leknes.   

Opioids Continue to Be Effective Long Term

Opioids Continue to Be Effective Long Term – Medscape – Fran Lowry – October 01, 2013

This is a good review with results that ring true in my experience,

Unfortunately, it’s fatally tainted by funding from Purdue.

An extensive literature review of studies evaluating the effectiveness of long-term opioid therapy in chronic noncancer pain (CNCP) concludes that the drugs continue to provide reliable and safe analgesia for 6 months or more.

“Due to FDA regulatory guidelines, most contemporary phase 3 randomized controlled trials of opioid analgesics for CNCP are 3 months long or less.  

PROP eases absolutist stance on opioid prohibition

Opioid Dose Tapering, Opioid Dependence, and Indications for Buprenorphine | Annals of Internal Medicine | American College of Physicians – September 2019

This article is significant only because its authors are all founding members of PROP, the group that initiated, escalated, inflamed, and essentially fabricated the whole issue with prescribed opioid medication:

• Roger Chou, MD;
• Jane Ballantyne, MD;
• Anna Lembke, MD.  

I’m delighted to see even a tiny crack in the seemingly invincible force of opioid prohibition.

Pain Takes Significant Toll on Cancer Survival

Pain Takes Significant Toll on Ovarian Cancer Survival, Study Shows – by Alberto Molano, PhD – Sep 2019

This study shows that constant pain is so damaging to health that it can shorten the life span. Any other symptom that led to such dismal outcomes would be treated aggressively and immediately as an emergency.

However, since pain is invisible and can only be determined by the patient themselves, it is doubted and left poorly treated, if at all. When pain medication is withheld from a patient, their constant pain can lead to an early death. This should be clear malpractice, but in today’s opioidphobic society doctors are pressured to do exactly that: leave pain poorly treated even though it’s detrimental to a patient’s health and welfare.

For the first time, scientists have found evidence that pain is an independent marker for overall survival in recurrent ovarian cancer, with women with pain living for significantly less time after their diagnosis than those without pain.

Effect of chronic opioid therapy on pain and survival

UMN researchers study effect of chronic opioid therapy on pain and survival in sickle cell disease | EurekAlert! Science News – Apr 2019

Though this article is specifically about Sickle Cell Disease, it can be applied to many other kinds of chronic pain.

New UMN research recently published Blood Advances, Kalpna Gupta, PhD, Professor of Medicine, University of Minnesota Medical School, demonstrates the impact of opioids on the survival of humanized mouse models with sickle cell disease, compared to normal mice.

Sickle Cell Disease (SCD) affects millions of people throughout the world. The genetic disease worsens over time and can cause lifelong pain.

Given the often severe nature of the pain associated with SCD opioid use is a rule not an exception for treatment.   

Pain control methods used by EDS patients

Pain control methods in use and perceived effectiveness by patients with Ehlers-Danlos syndrome: a descriptive study. – PubMed – Disabil Rehabil. 2016;

PURPOSE:
The purpose of this study was to assess the pain control methods in use by patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders, and their perceived effectiveness

METHOD:
This descriptive study involved 1179 adults diagnosed with EDS who completed an anonymous on-line survey. The survey consisted of

• demographics information, 
• the Patient Reported Outcomes Measurement Information System (PROMIS) Pain-Behavior,
• PROMIS Pain-Interference, and
• Neuro QOL Satisfaction with Social Roles and Activities scales, as well as a
• modified version of the Pain Management Strategies Survey.

Mortality After Discontinuation of Opioid Therapy for Pain

Mortality After Discontinuation of Primary Care-Based Chronic Opioid Therapy for Pain: a Retrospective Cohort Study. – PubMed – NCBI – J Gen Intern Med. – Aug 2019

BACKGROUND:

Despite known risks of using chronic opioid therapy (COT) for pain, the risks of discontinuation of COT are largely uncharacterized.

These “risks of discontinuation of COT” are not “largely uncharacterized” but rather completely unstudied.

Pain patients being tapered are being used as guinea pigs because those who are restricting opioids have no idea what the results might be. 

Management of chronic pain in EDS – part 2

Management of chronic pain in EDS – Nov  2018 – part 2

This post continues from the first part, with more detailed descriptions of various types of pain that arise from our tissue fragility and from consequences of related genetic changes.

3. Discussion

3.1 Chronic pain and EDS overview  (covered in previous post)

3.1.1 Musculoskeletal pain

Nociceptive, joint pain is usually the first manifestation of pain in EDS. 

Management of chronic pain in EDS – part 1

Management of chronic pain in Ehlers–Danlos syndrome: Two case reports and a review of the literature – journals.lww.com –  November 2018 – Part 1

I have a lot to say about this long article, so I’m going to break it into 3 separate posts:

Ehlers–Danlos syndromes (EDSs) are a heterogeneous group of heritable connective tissue disorders involving defective collagen synthesis.

Patients with EDS are prone for chronic myofascial pain, apart from other comorbidities.

Although the initial pathology is commonly nociceptive, progression of EDS leads to neuropathies and central sensitization of pain signals.  

List of Peer Reviewed Articles on Pain/Opioids

Peer-reviewed articles (2006-2019) on Pain/Opioids by Stefan Kertesz  (Twitter: @StefanKertesz)  June 2019

This is a collection of 26 scientifically correct (not anti-opioid) information that can be used as references to rebut the anti-opioid propaganda. Dr. Kertesz has been a powerful and respected advocate for us for many years and seems to be publishing voluminously.

Many of the articles below I’ve already posted, but here they are in a unified list of publications, most with links, which challenge the anti-opioid zealotry.