Opioids and abnormal pain perception: New evidence from a study of chronic oploid addicts and healthy subjects
Opioids and abnormal pain perception: New evidence from a study of chronic oploid addicts and healthy subjects
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DOI：
10.1016/j.drugalcdep.2005.09.007
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发表时间：
2006-05-20
影响因子：
4.2
通讯作者：
Eisenberg, E
中科院分区：
文献类型：
--
作者：
Pud, D;Cohen, D;Eisenberg, E
最近的证据报告说，动物在胃肠外给予类阿片后疼痛敏感性增加，人体在静脉注射短效类阿片后疼痛敏感性增加，吸毒成瘾者也可能出现疼痛敏感性增加。本研究的目的是探讨以下可能性：（1）慢性阿片类药物成瘾者（OAs）的疼痛感知发生改变;（2）如果确实如此，阿片类药物消费的停止重置了他们改变的疼痛感知。参加为期4周的住院戒毒计划的60名海洛因或美沙酮OAs在进入该计划后，在停止阿片类药物消费后的第7天和第28天（通过重复的尿液毒理学试验验证）暴露于冷加压试验（CPT）。测量疼痛发作的潜伏期、疼痛强度（0-100 VAS）和对CPT的耐受性（手撤回时间）。与70名健康对照组相比，OAs表现出延长的潜伏期（6.6 ± 3.5 s vs 10.9 ± 7.7 s; p < 0.0001）; VAS降低（74 16 vs 55 20; p < 0.0001）;耐受性更短（56.4 +/- 51.3 s vs 31.7 +/- 40.7 s; p = 0.001）。在OA中，未检测到三个时间点的三项测量值中的任何一项的差异。结果提供了OA人群中阿片类药物诱导的痛觉过敏的进一步证据，如他们更快的手撤回所表现的。此外，阿片类药物的解毒似乎至少在1个月内不会重置疼痛感知。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Recent evidence reported on increased pain sensitivity in animals following parenteral opioid administration and in humans subsequent to intravenously of short-acting opioids and possibly in drug addicts. The aims of the present study were to explore the possibilities that (1) pain perception is altered in chronic opioid addicts (OAs); (2) if indeed so, the cessation of opioid consumption resets their altered pain perception. Sixty heroin or methadone OAs who attended a 4-week inpatient detoxification program were exposed to the cold pressor test (CPT) upon entrance to the program, at 7 and 28 days subsequent to the cessation of opioid consumption (verified by repeated urine toxicology tests). Latency of pain onset (s), pain intensity (0-100 VAS), and tolerance (time for hand withdrawal) in response to the CPT were measured. In comparison with 70 healthy controls, the OAs demonstrated prolonged latency (6.6 +/- 3.5 s versus 10.9 +/- 7.7 s; p < 0.0001); decreased VAS (74 16 versus 55 20; p < 0.0001); shorter tolerance (56.4 +/- 51.3 s versus 31.7 +/- 40.7 s; p = 0.001). No differences between the three time points in any of the three measures were detected in the OAs. The results provide further evidence of opioid-induced hyperalgesia in the OA population, as manifested by their quicker hand withdrawal. In addition, it appears that detoxification from opioids does not reset pain perception for at least 1 month. (c) 2005 Elsevier Ireland Ltd. All rights reserved.