Study provides first evidence of link between opioid use disorder, chronic pain

This first-of-its-kind study explores central sensitization.

5:00 AM

Author | Eileen Scahill

woman sitting on bed blue shirt white sheets wall
Getty Images

Scientists have long noted a connection between opioid use disorder and chronic pain, however brain mechanisms linking opioid use disorder and chronic pain are poorly understood. This first-of-its-kind study by researchers at The Ohio State University Wexner Medical Center and College of Medicine and University of Michigan Medical School explored one potential mechanism – central sensitization – among individuals with opioid use disorder.

Central sensitization refers to abnormal pain processing in the brain and spinal cord. People with central sensitization have spinal cords that are unusually good at sending pain signals to the brain, and brains that struggle to turn off those signals once they arrive. This means people with greater central sensitization tend to suffer more with pain than others.

"Our study is the first to give patients with opioid use disorder a scale that measures central sensitization," said O. Trent Hall, lead author of the study and an addiction medicine physician in Ohio State's Department of Psychiatry and Behavioral Health. "Our study provides the first evidence of central sensitization underlying the chronic pain and OUD relationship and demonstrates a new tool for easily measuring central sensitization among individuals with opioid use disorder."

Like Podcasts? Add the Michigan Medicine News Break on Spotify, Apple Podcasts or anywhere you listen to podcasts.

Study findings are published in the journal PAIN Reports, an official journal of the International Association for the Study of Pain.

Researchers recruited 141 study participants from Ohio State Wexner Medical Center's addiction treatment center in Columbus, Ohio. As part of the study, researchers administered the American College of Rheumatology 2011 Fibromyalgia Survey Criteria via electronic survey. Participants also responded to questions about pain interference, quality of life and items regarding pain-beliefs and expectations of pain and addiction treatment.

Chronic pain may lead to opioid use disorder, and people with chronic pain and this disorder have a harder time quitting opioids than people with the disorder only. So, it's critical to find answers to how pain and opioid use disorder are connected in the brain. Researchers measured quality of life across eight life domains including general health, physical functioning, mental health, social functioning, vitality, bodily pain, role limitations due to physical health and role limitations due to emotional problems.

According to Hall, they found that greater central sensitization was associated with worse quality of life among patients with opioid use disorder.

"Additionally, patients higher in central sensitization were more likely to report pain as a major reason for why their opioid addiction first began, as well as for putting off addiction treatment, continuing and increasing their use of opioids, and fear of pain causing OUD relapse in the future," said senior author Daniel J. Clauw, M.D., director of the Chronic Pain and Fatigue Research Center at the University of Michigan.

This study suggests central sensitization may be an important underlying factor complicating the treatment of chronic pain and OUD. This provides an example for other clinicians and researchers to measure central sensitization in OUD, which could help them produce better treatments for people suffering with chronic pain and opioid use disorder.

As a physician with a background in both pain and addiction, Hall has cared for many patients suffering deeply with both conditions and he realizes that treatment options are limited.

"It's important to me to search for new ways to help," Hall said.

"But we can't create better treatments for chronic pain and opioid use disorder without first understanding how the two relate. I did this study because I believed it might offer a new window into what is happening in the brains of patients needing help with pain and addiction."

Clauw added: "We hope to put in a grant with the OSU team within the next year to expand upon these findings since we feel that treating opioid use disorder in someone with chronic pain should be quite different than someone without pain."

The team plans to follow patients with central sensitization and opioid use disorder over time to find out if they respond differently to treatments or have different outcomes and to study whether existing treatments for central sensitization are beneficial for patients with chronic pain and opioid use disorder.

Funding was provided by the Care Innovation and Community Improvement Plan (CICIP), a program of the Ohio Department of Medicaid. Clauw has testified in state lawsuits against opioid manufacturers for their role in the opioid overdose crisis. The remaining authors report no relevant conflicts of interest.

Paper cited: "Central sensitization in opioid use disorder: a novel application of the American College of Rheumatology Fibromyalgia Survey Criteria," PAIN Reports. DOI: 10.1097/PR9.0000000000001016

Live your healthiest life: Get tips from top experts weekly. Subscribe to the Michigan Health blog newsletter

Headlines from the frontlines: The power of scientific discovery harnessed and delivered to your inbox every week. Subscribe to the Michigan Health Lab blog newsletter


More Articles About: Body Work All Research Topics Addiction and Mental Illness Mental Health Mental Health Assessment Community Health Future Think Addiction and Substance Abuse
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories marijuana leaf drawing blue lab note yellow badge upper left corner
Health Lab
Data shows medical marijuana use decreased in states where recreational use became legal 
Data on medical cannabis use found that enrollment in medical cannabis programs increased overall between 2016 and 2022, but enrollment in states where nonmedical use of cannabis became legal saw a decrease in enrollment
Health Lab
What parents should know about teen drug and alcohol use
An expert from the University of Michigan Addiction Center shares the impacts of teen substance use and what families can do to help youth who may be at risk or showing signs of addiction.
Photo of a cluttered, messy garage
Health Lab
Chemicals stored in home garages linked to ALS risk
A Michigan Medicine study finds that storing chemicals in a garage at home may associate with an increased risk of ALS.
Mothers Babies Postpartum
Health Lab
Rapid rise seen in mental health diagnosis and care during and after pregnancy
Perinatal mental health research shows more pregnant people and those who have recently given birth are getting diagnosed and treated for depression, anxiety and PTSD, but disparities remain.
Photo of two silhouettes in a hallway
Health Lab
Most new doctors face some form of sexual harassment, even after #MeToo
Sexual harassment of all kinds is a common experience among first-year medical residents, also known as interns, especially those in surgical specialties, but it may be declining.
Four older women pose and smile
Health Lab
Unlocking the secrets of SuperAgers
People in their 80s and 90s with cognitive abilities similar to much younger people, called super agers, are taking part in a national study of their brain health.