• John W Burns, Stephen Bruehl, Christopher R France, Erik Schuster, Daria Orlowska, Melissa Chont, Rajnish K Gupta, and Asokumar Buvanendran.
• Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois. Electronic address: John_burns@rush.edu.
• J Pain. 2017 Aug 1; 18 (8): 923-932.

AbstractLong-term use of opioid analgesics may be ineffective or associated with significant negative side effects for some people. At present, there is no sound method of identifying optimal opioid candidates. Individuals with chronic low back pain (n = 89) and healthy control individuals (n = 102) underwent ischemic pain induction with placebo, opioid blockade (naloxone), and morphine in counterbalanced order. They completed the Spielberger Anger-Out subscale. Endogenous opioid function × Anger-out × Pain status (chronic pain, healthy control) interactions were tested for morphine responses to ischemic threshold, tolerance, and pain intensity (McGill Sensory and Affective subscales) and side effects. For individuals with chronic pain and healthy control participants, those with low endogenous opioid function and low anger-out scores exhibited the largest morphine analgesic responses, whereas those with high anger-out and low endogenous opioid function showed relatively weaker morphine analgesic responses. Further, individuals with chronic pain with low endogenous opioid function and low anger-out scores also reported the fewest negative effects to morphine, whereas those with low endogenous opioid function and high anger-out reported the most. Findings point toward individuals with chronic pain who may strike a favorable balance of good analgesia with few side effects, as well as those who have an unfavorable balance of poor analgesia and many side effects.Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

34 keywords...

hide…