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Opioid exposure causes brian changes. Some appear detrimental; some beneficial
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cweinbl posted:

Researchers at Stanford University, California, conducted a longitudinal, MRI study examining 10 individuals with chronic, moderate-to-severe, nonradicular low back pain who were administered long-acting oral morphine (MS-Contin) daily for 1 month [Younger et al. 2011>.[a name="more"> Brain imaging was conducted immediately before and after the morphine administration period, and a third time at an average follow-up of 4.7 months. Similar imaging was conducted on a separate group of 9 subjects with chronic low back pain, receiving a blinded placebo substance for the same time period, to serve as a control group for determining if any brain changes might occur that were not specific to opioid administration.

Results reported in the August 2011 edition of the journal PAIN indicate that 13 brain regions in morphine-administered subjects evidenced significant volumetric change, and the degree of change in several regions correlated with morphine dosage. Dosage-correlated volumetric, gray matter decreases were observed in limbic areas, primarily in the right amygdale. On the other hand, dosage-correlated volumetric increases were seen in select limbic and cortical structures: the right hypothalamus, left inferior frontal gyrus, right ventral posterior cingulate, and right caudal pons.

Prior evidence has demonstrated that chronic pain itself influences important changes in brain structure and function. In this current study, significant changes were observed in brain structure attributable to morphine administration. But here is the most important question for further research: Were these morphine-induced brain structure alterations potentially harmful or, equally likely, of benefit in helping to reverse the neurobiological damage of chronic pain and returning the brains of suffering patients to a more normal state?

While the authors imply that these neuroplastic changes might be detrimental, it seems equally likely that long-term opioid administration restores the pain-altered brain to a more normal, healthy state. Thus the increases in limbic matter in select limbic and cortical structures: (the right hypothalamus, left inferior frontal gyrus, right ventral posterior cingulate, and right caudal pons) might be the brain's way of compensating for the decreases in other limbic areas.

Much more research, using much larger groups, is in order. At this point (and we can only guess), the brain changes from chronic pain appear detrimental; but the changes from opioid administration may be both detrimental and beneficial. The body has miraculous recuperative capacity, perhaps expressed with the greatest complexity within brain structures. Thus a decrease in one part of the brain that correlates with opiate administration may well be compensated for by the brain's new increase in another structure.

Read the entire article and commentary here: http://updates.pain-topics.org/2011/07/brain-changes-wrought-by-opioid.html .
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