Non-Opioid Pathway Could Alter the Way We Treat Chronic Pain

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Non-Opioid Pathway Could Alter the Way We Treat Chronic Pain
Non-Opioid Pathway Could Alter the Way We Treat Chronic Pain

A new study has shed light on a non-opioid pain pathway in the brain, suggesting that a combined approach to pain relief may be best.

While mindfulness meditation has previously been associated with pain relief, the mechanistic action behind this has been unclear.

To better understand this, Fadel Zeidan, PhD, of the Wake Forest School of Medicine, and colleagues conducted a double-blind, randomized study of 78 healthy adults during meditation or a non-meditation control in response to noxious heat and intravenous administration of opioid antagonist naloxone or placebo saline. Participants were randomized to 4 treatment groups: meditation plus naloxone; control plus naloxone; meditation plus saline; or control plus saline. Control groups were told to “close your eyes and relax until the end of the experiment.”

Participants who meditated during saline administration showed significantly reduced pain intensity and unpleasantness ratings compared to the control plus saline group. Notably, naloxone infusion failed to reverse meditation-induced analgesia. No significant differences between pain intensity or unpleasantness was recorded between the meditation plus naloxone and meditation plus saline groups, suggesting that naloxone did not block the pain-relieving effects of meditation. Compared to control groups, those in the meditation plus naloxone group showed significantly greater reductions in pain intensity and unpleasantness.

“The results demonstrate that meditation-based pain relief does not require endogenous opioids,” the authors wrote in the study, which was published in the Journal of Neuroscience. “Therefore, treatment of chronic pain may be more effective with meditation due to lack of a cross-tolerance with opioid-based medications.”

Reference

Zeidan F, Adler-Neal AL, Wells RE, et al. Mindfulness-meditation-based pain relief is not mediated by endogenous opioids. J Neurosci. 2016; doi: 10.1523/JNEUROSCI.4328-15.2016.

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