OPIATE PHARMACOTHERAPY PAIN TOLERANCE AND ANALGESIC RESPONSE

阿片类药物治疗的疼痛耐受性和镇痛反应

• 批准号: 6270034
• 负责人: PEGGY COMPTON
• 金额: $ 49.16万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-15 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6270034
• 关键词: analgesics; drug abuse chemotherapy; drug administration rate /duration; human subject; methadone; opiate alkaloid; pain threshold

The proposed study seeks to evaluate pain tolerance and analgesic response in drug abusers receiving opiate maintenance treatment, a population for which pain management is a frequent and clinically challenging issue. Although overlap between brain systems responsible for both pain and opiate dependence is increasingly appreciated, little is known about the experience of pain for persons chronically ingesting exogenous opiates. Thus we propose to describe pain tolerance in opiate-maintained individuals and evaluate their response to analgesic medications. A methadone-maintained (n = 54), a buprenorphine-maintained (n = 54) and a LAAM-maintained (n = 54) sample will be recruited, and their tolerance to a standardized cold-pressor test (CPT) will be evaluated upon admission to treatment and again once they have stabilized on opiate maintenance to learn if and how pain tolerance changes over the course of opiate maintenance treatment. The CPT analgesic response of these stabilized subjects will be evaluated by double blind administration of oral opiate (Dilaudid, 3 mg.), non-opiate (Toradol, 10 mg.), and placebo using a Latin square design, and compared to that noted in a sample of matched controls. Proposed analyses will provide information on 1) pain tolerance for treatment-seeking opiate addicts, 2) pain tolerance for three opiate- maintained samples, 3) analgesic agents which are effective for opiate- maintained persons, and 4) potential differences in pain response between persons maintained on methadone, buprenorphine and LAAM. It is anticipated that the findings from the proposed study will have important clinical implications for the assessment and treatment of pain in this population which is prone to painful morbidity.

这项拟议的研究旨在评估疼痛耐受性和镇痛反应 在接受阿片剂维持治疗的药物滥用者中， 其中疼痛管理是常见的和临床上具有挑战性的问题。 虽然负责疼痛和疼痛的大脑系统之间存在重叠， 鸦片依赖越来越多地被认识到，对鸦片依赖知之甚少。 长期摄入外源性鸦片类物质的人的疼痛体验。 因此，我们建议描述阿片维持的疼痛耐受性 并评估他们对镇痛药物的反应。 一 美沙酮维持组（n = 54）、丁丙诺啡维持组（n = 54）和 将招募LAAM维持的（n = 54）样本，并评估其对 标准化冷加压试验（CPT）将在入院时进行评估， 治疗，并再次一旦他们已经稳定对阿片类药物的维持， 了解阿片类药物治疗过程中疼痛耐受性是否以及如何变化 维持治疗。 这些稳定的CPT镇痛反应 受试者将通过口服阿片剂的双盲给药进行评价 （二氢吗啡酮，3 mg），非阿片类药物（Toradol，10 mg），和安慰剂使用拉丁文 正方形设计，并与匹配对照样本中的结果进行比较。 拟定的分析将提供以下信息：1） 寻求治疗的阿片类药物成瘾者，2）对三种阿片类药物的疼痛耐受性- 维持的样品，3）对阿片类药物有效的镇痛剂- 维持的人，和4）之间的疼痛反应的潜在差异 接受美沙酮、丁丙诺啡和LAAM治疗的人。 是 预计拟议研究的结果将具有重要意义。 评估和治疗疼痛的临床意义， 容易出现疼痛性发病的人群。