Central sensitization may be an important underlying factor complicating treatment
The study provides the first evidence of the Introduction:
The central sensitization (CS) involves dysfunctional central nervous system pain modulation resulting in heightened pain perception. Central sensitization is not commonly assessed in patients with opioid use disorder (OUD), even though pain has been implicated in the development, maintenance, and relapse of TOU, and the Chronic use of opioids can lead to opioid-induced hyperalgesia. . Central sensitization is a plausibly important mechanism underlying the complex relationship between OUD and chronic pain. However, this premise is largely unproven.
Participants with OUD (n=141) were recruited from an academic drug treatment center in Columbus, Ohio. An established surrogate measure of CS, the 2011 Fibromyalgia Survey Criteria of the American College of Rheumatology, by means of an electronic survey. Participants also answered questions about pain interference (Brief Pain Inventory), quality of life (RAND-36), and items related to beliefs and expectations about pain and addiction treatment. Descriptive analyses, Spearman rho correlations and Mann-Whitney U tests were performed.
Hypothetical relationships between CS grade, pain interference, and health-related quality of life were confirmed.
The degree of CS was also positively correlated with greater acceptance of pain as a reason for initiating, maintaining, and increasing OUD; delay in processing; and relapse of OUD. Participants with American College of Rheumatology 2011 Fibromyalgia Survey criteria ≥ 13 had significantly higher approval of pain as a reason for delaying UDO treatment, continuing, and increasing use of opioids and precipitate relapse of UDO.
Frequency of self-reported pain by body region. Anatomical illustration of the ACR-FMS/Michigan.14 ACR-FMS body map, American College of Rheumatology 2011 Fibromyalgia Survey Criteria.
This study provides preliminary evidence that CS may underlie previously observed links between clinically salient features of chronic pain and OUD, which could inform future mechanistic research and precision treatment.
This study, the first of its kind, led by researchers from Ohio State University Wexner Medical Center and the University of Michigan Medical School and College of Medicine, explored a potential mechanism, central sensitizationamong people with opioid use disorder (OUD).
Scientists have long noted a link between opioid use disorder (OUD) and chronic painHowever, the brain mechanisms linking OUD and chronic pain are poorly understood. This study, the first of its kind, explored a potential mechanism, central sensitizationamong people with OUD.