Pain
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In the population of chronic pain patients seen at multidisciplinary pain clinics, excessive and/or inappropriate medication use is a frequent problem. This study examined differences between chronic pain patients who used no addicting medication (30% of the sample of 131 patients), those who used narcotic but not sedative medications (33%) and those who used both narcotic and sedative medications (37%). ⋯ Narcotic-sedative patients spent significantly more money on pain medication per month, reported significantly greater physical impairment, and had higher MMPI hypochondriasis and hysteria scores when compared to the other patients. The findings are interpreted in light of the hypothesis that certain patients show greater readiness to complain of and seek help for physical symptoms.
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Spinothalamic tract cells in anesthetized monkeys were found to respond to noxious cold stimuli (18/19 cells tested), as well as to noxious heat and noxious mechanical stimuli. Responses to repetition of the noxious cold stimuli after a series of noxious heat stimuli were enhanced. ⋯ Thus, damage to a region of skin can result in enhanced responsiveness of spinothalamic cells to stimuli applied in an undamaged region of the receptive field. The possible relationship between these observations and cutaneous hyperalgesia is discussed.
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In a pain management program (200 patients), a group of daily users of oxycodone compound (29 patients) and a subgroup who were taking a "high dose" of oxycodone compound (13 patients) were compared with a group of 171 non-users of oxycodone compound. A significantly lower treatment success rate was observed in the users (P = 0.04) and high-dose users (P = 0.03). ⋯ Continued study of these findings is necessary. Meanwhile, in patients with chronic pain, there should be cautious use of this compound.