New hope for treating chronic pain without opioids

https://www.eurekalert.org/pub_releases/2021-02/uom-nhf021521.php

 

News Release 15-Feb-2021
University of Michigan

 

According to some estimates, chronic pain affects up to 40% of Americans, and treating it frustrates both clinicians and patients--a frustration that's often compounded by a hesitation to prescribe opioids for pain.

A new study from the University of Michigan School of Dentistry confirms that a low dose of a drug called naltrexone is a good option for patients with orofacial and chronic pain, without the risk of addiction, said first author Elizabeth Hatfield, a clinical lecturer in the Department of Oral and Maxillofacial Surgery and Hospital Dentistry.


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Low-dose naltrexone has been used off-label for years to treat chronic pain, but Hatfield said this is the first in-depth, systematic review of the literature to determine if the drug is indeed a good option for patients and deserving of more formal study.

"We found a reduction in pain intensity and improvement in quality of life, and a reduction in opioid use for patients with chronic pain," said Hatfield, who hopes to initiate a randomized control trial of low dose naltrexone.

Low doses of naltrexone (0.1-4.5 mg) works by acting on a unique cellular pathway in the nervous system through which it delivers chronic pain relief without opioids, Hatfield said. If patients are working with a physician to treat pain, it's appropriate for them to raise the topic of low-dose naltrexone as a possible alternative.

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It is best used on centralized pain disorders, conditions where the nervous system is in that hyperexcited state, Hatfield said. Those conditions include myalgia, complex regional pain syndrome and temporomandibular joint disorders, commonly called TMJ, among others. Low-dose naltrexone is inexpensive and has few side effects. However, it's not an option for people who use alcohol or opioids regularly.

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