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Pain and Chemical Dependency News
Many patients with chronic pain have less than optimal therapeutic outcomes
after prolonged treatment with opiate analgesics. Worsening of pain perception,
functional capacity, and mood often result. Medical detoxification is often
undertaken in this situation. Ninety-five consecutive patients (49 men and 46
women; age range, 26-84) with chronic noncancer pain were referred by local
pain clinics for detoxification from long-term opiate analgesic therapy. All
patients had increasing pain levels, worsening functional capacity, and, in
8%, the emergence of opiate addiction. Length of prior long-term therapy ranged
from 1.5 to 27 years (mean, 8.8 years). After a minimum of 12 hours of abstinence
from all opiate analgesics, patients were given low doses of sublingual (SL)
buprenorphine or buprenorphine/naloxone. Maintenance dosing was individualized
to treat chronic pain. Daily SL dose of buprenorphine ranged from 4 to 16 mg
(mean, 8 mg) in divided doses. Mean duration of treatment is 8.8 months (range,
2.4-16.6 months).
At clinic appointments, patients were assessed for pain, functional capacity,
and mood. Eighty-six percent of patients experienced moderate to substantial
relief of pain accompanied by both improved mood and functioning. Patient and
family satisfaction was robust. Only 6 patients discontinued therapy secondary
to side effects and/or exacerbation of pain. In this open-label study, SL buprenorphine
and buprenorphine/naloxone were well tolerated and safe and appeared to be effective
in the treatment of chronic pain patients refractory to long-term opiate analgesic
therapy. Malinoff HL, Barkin RL, Wilson G. Adapted from Am J Ther. 2005 Sep-Oct;12(5):379-84.
Read more: PMID 16148422
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16148422&query_hl=2
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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