[HN Gopher] Researchers uncover potential non-opioid treatment f...
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Researchers uncover potential non-opioid treatment for chronic pain
in mice
Author : ulrischa
Score : 35 points
Date : 2024-02-03 19:37 UTC (3 hours ago)
(HTM) web link (news.utexas.edu)
(TXT) w3m dump (news.utexas.edu)
| dataangel wrote:
| There are two types of people with chronic pain though:
|
| 1) People with a known condition like specific cancers where
| chronic pain can be a well understood aspect of the condition.
| Taking the meds doesn't hide anything you and the doctor aren't
| already aware of.
|
| 2) People lumped into a bucket diagnosis (IBS, Fibromyalgia, etc)
| because the docs don't actually know what's wrong. Taking pain
| meds is the equivalent of dismissing alerts without
| investigating. Prior to the opioid crisis even well meaning docs
| were eager to prescribe because it made patients feel better
| without addressing any underlying cause.
| metalcrow wrote:
| The metaphor isn't quite right, because in a lot of cases for
| #2, the docs still are searching for an underlying reason, but
| there has to be some treatment in the meantime while research
| is ongoing. It's like dismissing the same alert that is
| repeatedly popping up. You know about it and are hunting for
| the reason, but you can't work if it keeps appearing over and
| over again.
| codingdave wrote:
| This feels like an over-simplification.
|
| For bucket #1, you still may be covering up new problems. Just
| because you have reason A for pain doesn't mean reason B won't
| crop up later. You need to watch for changes and get them
| checked out, hoping you aren't covering up anything new. For
| bucket #2, those in that bucket still need to find a way to
| make their life better. Opioids are not ideal. But living in
| pain isn't ideal either. I think most people try to find non-
| opioid medications or coping mechanisms, but at the end of the
| day you gotta find a way to live your life.
| jki275 wrote:
| While true, when you live with the kind of pain they're talking
| about sometime you just need the pain to go away because you
| can't live your life otherwise. Doesn't mean you ignore the
| cause but the pain itself is destroying your life.
| r0ze-at-hn wrote:
| On #2 I have seen low dose naltrexone work really well which is
| amusing given its counterintuitive nature as an opioid
| antagonist. This was a fun puzzle to think about.
|
| My current best guess on how it work starts with the fact that
| when taken in low doses that only last a few hours it results
| in upregulation of the opioid receptors. A high level pathway
| you have for pain and turning off the pain would be:
|
| Pain stimulates nociceptors => increased substance P =>
| increased cytokines, chemokines, etc => increased T-lymphocyte
| => increased b-endorphins => inhibit substance P
|
| So with LDN less b-endorphins is needed to "turn off the pain"
| and you now get a shorter pain on / pain off cycle or really a
| shorter substance P cycle.
|
| It's obvious first use is when the opioid receptors have been
| down regulated, but it has lots of extra benefits for instance,
| the immune response is time limited to the necessary duration
| of pain, reducing the likelihood of autoimmune complications.
| Additionally, diminished cytokine levels result in less
| hypothalamic activation, mitigating excessive appetite (not to
| mention better TRH response). This helps many with fibromyalgia
| may struggle with weight management. Numerous other secondary
| effects have been documented over time (last 40ish years),
| underscoring the multifaceted impact of low-dose naltrexone.
|
| However, I agree that it is crucial to acknowledge that while
| this can effectively alleviate symptoms, it may also mask
| underlying issue(s). That could be something as simple as Zinc
| deficiency (due to diet or genetic predisposition) or more
| complicated such as classic like EDS.
| loeg wrote:
| (In mice.)
| dang wrote:
| Inmiced. Thanks!
| robg wrote:
| _Now researchers...have identified a molecule that reduces
| hypersensitivity in trials in mice by binding to a protein they
| have shown is involved in neuropathic pain._
| lupusreal wrote:
| Standard OTC doses of ibuprophen combined with acetaminophen (aka
| paracetamol) is an effective treatment for all but the most
| severe chronic pain.
| mtreis86 wrote:
| Ibuprophen is bad for your stomach, acetaminophen is bad for
| your liver, neither makes a good long term treatment.
| https://www.ncbi.nlm.nih.gov/books/NBK310269/
| https://www.ncbi.nlm.nih.gov/books/NBK548162/
| petesergeant wrote:
| The link you've posted says paracetamol is bad for your liver
| in overdose and "harmless" at normal low dose
| oooyay wrote:
| NSAIDs are pretty dangerous on the whole. It's kinda surprising
| they remain OTC while something like marijuana is schedule 1.
| This study encapsulates things pretty well:
| https://pubmed.ncbi.nlm.nih.gov/16086703/
| genocidicbunny wrote:
| Anecdotally, only for brief pain. For chronic daily pain, they
| have a high potential of causing stomach and hepatic problems.
| Sensitivity or allergy to NSAIDs is also not all that uncommon
| either. Several people I know cannot take any, or prolonged
| courses of NSAIDs due to their reactions.
| spacephysics wrote:
| Let's hope they also promise this is non-addictive for years and
| have little accountability besides a financial slap on the wrist
| /s
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