I’ve been told before that opiates aren’t useful for chronic pain, but I always assumed that was due to the risk of addiction. I had major surgery recently and was on morphine in the hospital and Vicodin after leaving. I hardly experienced any pain from the surgical site while on the medications, but my chronic shoulder pain seemed to be unaffected. Can anyone explain why this would be the case?
In: Biology
The addiction is one part, but the other part is tolerance. The more you take, the more it takes to get the same effect next time. It makes addiction worse too.
Basically, pain pathways are complex and chronic pain pathways are different than acute pain pathways. The way it was described to me is that, once pain shifts from acute to chronic, its pathway becomes ingrained. Opiates work by blocking pain signals between the body and the brain, but with chronic pain part of your brain is already primed to experience it. The call is coming from inside the house. That’s why antidepressants have been known to help.
I find weed effective. It doesn’t take the pain away entirely, but it certainly takes the edge off.
If you are alive, you have a liver and a brain.
Too much med in the brain, the brain make a bunch of complicated pathways and upregulation/downregulation (certainly not ELI5) that make the brain less sensitive to that medication.
Too much med in the liver, the liver make a bunch of complex metabolic pathways (certainly not ELI5) that make the med go away faster in the blood.
The simpler the structure of the med, the simpler it is for the brain and the liver to adjust to the med and make it look like the med is not working, because, in fact, the med is now only preventing withdrawal syndromes, but not having a direct beneficial effect.
Issues with narcotics for chronic pain. The need for tolerance breaks is not well established. The rate of abuse/addiction is high.
It is processed by the liver, and can damage it over time.
They were over-prescribed, and it lead to an epidemic of addiction and deaths.
Used responsibly, they can help manage pain. It’s important to keep checking liver health every 3 months or so tho.
No one is really answering this person’s question beyond the body wants pain to get thru, why was his shoulder hurting while on pain medication for something else?
From what I understand, narcotics like opiates work by blocking pain signals in the brain. However, over time the body can build up a tolerance to these drugs, meaning higher and higher doses are needed to achieve the same pain relief. This can lead to addiction and other negative side effects. In the case of chronic pain, the underlying condition causing the pain may not be affected by the pain-blocking properties of narcotics, meaning they may not provide much relief. It’s important to work with a healthcare professional to find the best treatment plan for your specific pain condition.
“Chronic pain” is a kind of catch-all term for “[pain that lasts longer than the expected period of recovery](https://en.wikipedia.org/wiki/Chronic_pain).” [Chronic pain is not a single clinical entity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736598/) and [management is complex](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736454/); opioids are useful in some cases, unhelpful in others.
The statement that “opiates aren’t useful for chronic pain” may be rooted in the fact that current government hysteria over the “opioid crisis” makes prescribing opioids for chronic pain impractical for most physicians in the United States, whether it would help the patient lead a better life or not.
Been on opiates for 12 years now due to severe DDD in lower back. They definitely do work long term. And I have decreased the level with other medications and devices like a spinal cord stimulator. I have weaned myself off of the opiates a couple of times in those 12 years, but the pain always comes back. I used to be on 50 mg of morphine sulfate, now I only need 15.
Chronic pain is often caused by changes in the nervous system, which makes it less responsive to opioid painkillers. While opioids can provide relief for acute pain, they are not as effective for long-term pain management.
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