When I saw this tweet from Stanford University Pain this week, I was intrigued.
Stanford and @Duke Anesthesia researchers find brain data to explain why fibromyalgia patients may feel benefit from opioids even though opioids may not work better to reduce chronic pain.
They referred to this article, which I suggest you read.
While the use of long-term opioid medications might not be beneficial for chronic pain per se (i.e., in terms of not improving physical function and not reducing pain interference for example), it is possible that opioid medications could be benefiting brain reward processing and associated reward behavior in patients with chronic pain.
Because the piece was specifically about fibromyalgia, it prompted me to ask Dr. Ginevra Liptan in Oregon what she thought of the study and its conclusion. Her comment was characteristically direct.
“Although it seems you hear nothing but bad news about opioids these days, a new study reports a beneficial effect of opioids on the fibromyalgia brain! Scans demonstrated that those patients taking chronic opioids had normal neural reward responses compared to abnormal responses in those not taking opioids.”
She continued, “This supports what I see in the clinic every day, with patients reporting less pain, improved function and quality of life due to opioids. However, since opioids are so controversial the researchers end the article by saying “We therefore encourage readers not to extrapolate these findings to suggest that opioids may, or may not, be of value in the treatment of fibromyalgia”.”
Fibromyalgia is one of the most common chronic pain conditions. The disorder affects an estimated 10 million people in the U.S. and an estimated 3-6% of the world population. While it is most prevalent in women —75-90 percent of the people who have it are women —it also occurs in men and children of all ethnic groups.
Among those 10 million people who have fibromyalgia is Dr. Liptan. Her Frida Center for Fibromyalgia is believed to be the first practice in the U.S. devoted to the treatment of fibromyalgia.
By the way, if you are on Twitter and not following @StanfordPain, you’re missing something. It is one of the most active Twitter accounts on chronic pain—and almost always interesting.