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High-Dose Opioids Can help Conquer Chronic Pain
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cweinbl posted:
Contrary to concerns professed lately by opponents of opioid analgesia, higher than usual doses of these medications could be just the thing to prevent acute pain from becoming a chronic, life-changing malady. As was recently successfully demonstrated in a preclinical study, the concept of early, short-term, high-dose opioid administration to quickly manage pain is a radical departure from usual practice and may offer interesting possibilities for better pain care.

In the study — published recently in the journal Science [Drdla-Schutting et al. 2012>, and further reported in the journal Nature [Frood 2012> — researchers at the Department of Neurophysiology, Center for Brain Research, Medical University of Vienna, report discovering new effects of opioids when given at a very high dose rather than continuously at typical lower does.

There has been some discussion in the literature that, by treating acute pain of various types quickly and aggressively, the chances of it becoming a chronic condition might be reduced. However, opioids are often avoided if possible as acute-pain therapy, and the current advice of "start low and go slow" when it comes to opioid dosing might actually favor in certain cases the development of long-term potentiation (LTP) that fosters chronic pain. Perhaps, what is most needed is higher rather than lower opioid dosing at the outset, at least for a brief period of time and, certainly, under safe conditions.
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