Living with chronic pain can be both frustrating and debilitating. It’s no wonder that some chronic pain patients are willing to try just about anything to feel better. This includes naltrexone, a synthetic opioid normally used to combat the effects of natural opioids and alcohol. But is a synthetic opioid the best way to go?
Patients visiting one of the pain doctors at Lone Star Pain Medicine in Weatherford, Texas are likely to hear about a range of treatments that do not rely on long-term pain medication. Steroid injections and blocks are but two examples. Yet these types of treatments are designed to target specific and known pain. When chronic pain is more general, such targeted treatments might not work.
According to a Medical Xpress post from University of Michigan (UM) contributor Laura Bailey, using naltrexone as a treatment for chronic pain targets more general pain. It seems to work based on how it interacts with the central nervous system.
Low Dose Without Addiction
Bailey says that a recently released study from the University Of Michigan School of Dentistry suggests that low doses of naltrexone can help relieve orofacial and chronic pain with very little risk of addiction. The study looked at the potential of prescribing low doses of between 0.1 and 4.5 mg.
For the record, naltrexone was developed in the 1960s as a drug to counteract the effects of opioid overdose. It is commonly used for that purpose in doses of between 50 and 100 mg. Such high doses over long periods of time increase the risk of addiction. But the lower doses UM researchers looked at are apparently not high enough to create addiction.
Calming the Central Nervous System
Though more research is necessary, the UM team seems to believe that naltrexone works as a treatment for chronic pain by calming the central nervous system. As the thinking goes, chronic pain resulting from a previous injury may be due more to how the nervous system reports pain than the injury itself.
In her piece, Bailey explained that any sort of injury can cause the nervous system to become hypersensitive. That hypersensitivity can remain even after the injury itself is healed. Thus, the patient continues to experience pain. Naltrexone apparently addresses the phenomenon by slowly desensitizing the nervous system again.
Like all opioids – both natural and synthetic – naltrexone affects certain chemical receptors in the brain. Binding to those receptors inhibits their function. The end result is a lower pain threshold and a less sensitive nervous system.
For Centralized Pain Disorders
UM researchers hope to conduct randomized, clinical studies of naltrexone in the future. For now, some doctors may prescribe it off-label for centralized pain disorders. Fibromyalgia is one example that immediately comes to mind. Complex regional pain syndrome is another good candidate.
Again, it is important to note that the discussion centers around centralized pain disorders. Specific pain related to conditions like osteoarthritis and herniated discs are best addressed with more targeted treatments. For example, osteoarthritis pain can be managed with steroid injections, analgesics, and physical therapy.
Naltrexone is not the ideal treatment option for every chronic pain condition. It might not even prove effective for a wide variety of centralized pain disorders. But even if it works for only one or two conditions, it could help patients who cannot find relief in any other way.
Is a synthetic opioid the best way to treat chronic pain? It might be in some cases. Research done thus far looks promising. More research is necessary to confirm what UM scientists have already discovered.