Effects of Short-Term Oxycodone Maintenance on Experimental Pain Responses in Physically Dependent Opioid Abusers

Coe, Marion A.; Nuzzo, Paul A.; Lofwall, Michelle R.; Walsh, Sharon

doi:10.1016/j.jpain.2017.02.433

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Often patients suffering from chronic pain due to these conditions are prescribed highly addictive opioids for pain management. Because of the nature of opioids, patients are continually prescribed higher doses of medication due to a buildup of tolerance, which can eventually lead to addiction and in certain cases death . In February 2018, The International Association for the Study of Pain (IASP) recognized that longer‐term use, tolerance, dependence, and other neuroadaptations of opioids compromise both efficacy and safety .…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Venuturupalli

Chu²,

Vicari³

et al. 2019

ACR Open Rheumatology

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Objective. As technology continues to improve, it plays an increasingly vital role in the practice of medicine. This study aimed to assess the feasibility of the implementation of virtual reality (VR) in a rheumatology clinic as a platform to administer guided meditation and biofeedback as a means of reducing chronic pain.Methods. Twenty participants were recruited from a rheumatology clinic. These participants included adults with physician-diagnosed autoimmune disorders who were on a stable regimen of medication and had a score of at least 5 on the pain Visual Analog Scale (VAS) for a minimum of 4 days during the prior 30 days. VAS, part of most composite outcome measurements in rheumatology, is an instrument used to assess pain that consists of a straight line with the endpoints ranging from "no pain at all" and "pain as bad as it could be." Patients were randomized into two groups that differed in the order in which they experienced the two VR modules. One module consisted of a guided meditation (GM) environment, whereas the other module consisted of a respiratory biofeedback (BFD) environment. Data on pain and anxiety levels were gathered before, during, and after the two modules.Results. The three most common diagnoses among participants were rheumatoid arthiritis (RA), lupus, and fibromyalgia. There was a significant reduction in VAS scores after BFD and GM (P values = 0.01 and 0.04, respectively). There was a significant reduction in Facial Anxiety Scale after the GM compared with the BFD (P values = 0.02 and 0.08, respectively).Conclusion. This novel study demonstrated that VR could be a feasible solution for the management of pain and anxiety in rheumatology patients. Further trials with varying treatment exposures and durations are required to solidify the viability of VR as a treatment option in rheumatology clinics.

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Section: Introductionmentioning

confidence: 99%

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Venuturupalli

Chu²,

Vicari³

et al. 2019

ACR Open Rheumatology

View full text Add to dashboard Cite

show abstract

“…Quantitative sensory testing includes standardized acute exposures to hot or cold temperatures as well as pressure algometry applied to the skin, and correlates with acute opioid pain relief achieved during clinical treatment in the emergency room 19 and post-operatively 20 . However, quantitative sensory testing has rarely been used to examine analgesic response in patients with opioid use disorder 21 , 22 .…”

Section: Introductionmentioning

confidence: 99%

Analgesic Effects of Hydromorphone versus Buprenorphine in Buprenorphine-maintained Individuals

et al. 2019

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EDITOR’S PERSPECTIVE What We Already Know about This Topic The prevalence of patients prescribed buprenorphine for treatment of opioid use disorder is increasing Managing acute pain in buprenorphine-maintained individuals can be challenging What This Article Tells Us That Is New Large doses of intravenous hydromorphone can provide analgesia in buprenorphine-maintained individuals However, the use of hydromorphone for analgesia in buprenorphine-maintained individuals confers greater abuse liability and side effects than does supplemental intravenous buprenorphine Background Managing acute pain in buprenorphine-maintained individuals in emergency or perioperative settings is a significant challenge. This study compared analgesic and abuse liability effects of adjunct hydromorphone and buprenorphine using quantitative sensory testing, a model of acute clinical pain, in persons maintained on 12 to 16 mg sublingual buprenorphine/naloxone. Methods Participants (N = 13) were enrolled in a randomized within-subject, double-blind, placebo-controlled three-session experiment. Each session used a cumulative dosing design with four IV injections (4, 4, 8, and 16 mg of hydromorphone or 4, 4, 8, and 16 mg of buprenorphine); quantitative sensory testing and abuse liability assessments were measured at baseline and after each injection. The primary analgesia outcome was change from baseline cold pressor testing; secondary outcomes included thermal and pressure pain testing, as well as subjective drug effects and adverse events. Results A significant two-way interaction between study drug condition and dose was exhibited in cold pressor threshold (F10,110 = 2.14, P = 0.027) and tolerance (F10,110 = 2.69, P = 0.006). Compared to after placebo, participants displayed increased cold pressor threshold from baseline after cumulative doses of 32 mg of IV hydromorphone (means ± SD) (10 ± 14 s, P = 0.035) and 32 mg of buprenorphine (3 ± 5 s, P = 0.0.39) and in cold pressor tolerance after cumulative doses of 16 mg (18 ± 24 s, P = 0.018) and 32 mg (48 ± 73 s, P = 0.041) IV hydromorphone; cold pressor tolerance scores were not significant for 16 mg (1 ± 15 s, P = 0.619) or 32 mg (7 ± 16 s, P = 0.066) buprenorphine. Hydromorphone and buprenorphine compared with placebo showed greater ratings on subjective measures of high, any drug effects, good effects, and drug liking. Adverse events were more frequent during the hydromorphone compared with buprenorphine and placebo conditions for nausea, pruritus, sedation, and vomiting. Conclusions In this acute clinical pain model, high doses of IV hydromorphone (16 to 32 mg) were most effective in achieving analgesia but also displayed higher abuse liability and more frequent adverse events. Cold pressor testing was the most consistent measure of opioid-related analgesia.

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Methadone maintenance patients lack analgesic response to a cumulative intravenous dose of 32 mg of hydromorphone

Agin-Liebes

Huhn

Strain

et al. 2021

Drug and Alcohol Dependence

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Effects of Short-Term Oxycodone Maintenance on Experimental Pain Responses in Physically Dependent Opioid Abusers

Cited by 4 publications

References 33 publications

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Analgesic Effects of Hydromorphone versus Buprenorphine in Buprenorphine-maintained Individuals

Methadone maintenance patients lack analgesic response to a cumulative intravenous dose of 32 mg of hydromorphone

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