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Pain responses in methadone-maintained opioid abusers.

P Compton1, V C Charuvastra, K Kintaudi

  • 1School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095-6918, USA.

Journal of Pain and Symptom Management
|October 12, 2000
PubMed
Summary
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Individuals in methadone-maintenance (MM) treatment show lower pain tolerance than controls. Pain management for opioid abusers requires serious evaluation and aggressive treatment strategies due to their pain intolerance.

Area of Science:

  • Pain Management
  • Addiction Medicine
  • Clinical Pharmacology

Background:

  • Pain management for opioid abusers is clinically challenging due to limited understanding of their pain experience.
  • Opioid dependence significantly impacts pain perception and analgesic needs.
  • Methadone-maintenance (MM) treatment is a common approach for managing opioid addiction.

Purpose of the Study:

  • To compare pain tolerance and analgesic response in individuals on methadone-maintenance (MM) treatment versus non-dependent controls.
  • To investigate the effects of opioid and non-steroidal anti-inflammatory drugs on pain tolerance in this population.
  • To characterize the pain experience of opioid-addicted patients undergoing MM treatment.

Main Methods:

  • A placebo-controlled, two-way factorial design was employed.

Related Experiment Videos

  • Pain tolerance was assessed using the cold-pressor (CP) test.
  • Participants included 60 individuals in MM treatment and 60 matched controls.
  • Analgesic response was measured after administration of hydromorphone (2 mg) and ketorolac (10 mg).

    • Main Results:

    • Individuals in MM treatment demonstrated significantly lower tolerance to CP pain compared to control subjects.
    • No significant analgesic effects were observed for either medication (hydromorphone or ketorolac) across groups.
    • The findings suggest a distinct pain profile for opioid-dependent individuals.

    Conclusions:

    • Opioid abusers in MM treatment represent a pain-intolerant patient subset.
    • Clinical evaluation of pain complaints in these patients should be taken seriously.
    • Aggressive and tailored pain management strategies are warranted for opioid-addicted patients.