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Updated: Jul 28, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
Published on: April 14, 2016
Blinded Pain Cocktails: A Reliable and Safe Opioid Weaning Method
Albert Hyukjae Kwon1, Luana Colloca2, Sean C Mackey3
1Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor, Redwood City, CA 94063, USA.
Abstract:
Weaning opioids in patients with noncancerous chronic pain often poses a challenge when psychosocial factors complicate the patient's chronic pain syndrome and opioid use. A blinded pain cocktail protocol used to wean opioid therapy has been described since the 1970s. At the Stanford Comprehensive Interdisciplinary Pain Program, a blinded pain cocktail remains a reliably effective medication-behavioral intervention. This review (1) outlines psychosocial factors that may complicate opioid weaning, (2) describes clinical goals and how to use blinded pain cocktails in opioid tapering, and (3) summarizes the mechanism of dose-extending placebos and ethical justification of its use in clinical practice.
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