As the national opioid epidemic continues to claim thousands of lives every year, doctors are increasingly questioning the value and efficacy of using this category of drugs to treat chronic pain–and finding that, in some cases, they actually make pain worse.
The Hopkins study looked at sickle cell disease, a rare genetic blood disorder that predominantly affects African-Americans, and that can result in severe pain, both in temporary and chronic. That pain is often treated with opioids, as many kinds of chronic pain are.
But when the researchers asked sickle cell patients to report back about their daily levels of fatigue, pain, and activity, they found that those who were on long-term opioid treatment actually fared much worse than those who were not. In fact, the patients on opioids seemed to actually experience more pain, showing higher levels of central sensitization–which is a phenomenon where the body amplifies pain sensations and increases sensitivity to pain.
“We need to be careful and skeptical about giving increasing doses of opioids to patients with sickle cell disease who are in chronic pain if it isn’t effective,” says C. Patrick Carroll, M.D, director of psychiatric services for the Johns Hopkins Sickle Cell Center for Adults and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “Too little is known about the effects of long-term opioid management of chronic pain.”
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