Column #141

Once again the medical community loses another round in the opioid crisis. Two and a half years ago I wrote about this in “Can Food Compete with Pills?” You may recall this line, “Fully 25% of Oregon’s four million residents take prescription opioids.” Since then the problem has gotten worse.

Some people believe the opioid epidemic was caused in part because in the 1990s the pharmaceutical industry assured the government that prescription opioids were safe. Now it’s estimated that in 2017 there were more than 66,000 overdose deaths. And wouldn’t you know it, paradoxically, with all these pain killers people may be living with even more pain than ever.

On April 16, 2018, Watkins and co-author Peter Grace (scientists at the University of Colorado Boulder) published a study that strongly suggests opioids after surgery can prolong pain and lead to chronic pain. They tested opioid use by performing exploratory abdominal surgery, or laparotomy, on male rats. It’s a similar procedure that’s done on tens of thousands of people annually in the United States where opiates are routinely used after surgery. Their findings were surprising.

Grace, now an assistant professor at MD Anderson Cancer Center in Houston, said this about the motivation for the study: “Opiates are really effective for acute pain relief. There is no drug that works better. But very little research has been done to look at what it is doing in the weeks to months after it’s withdrawn.”

What they learned was that when opioids are administered to animals to quell pain after surgery, their pain was prolonged more than three weeks beyond the time of other animals not treated with opioids. They also noted that the pain killers actually primed specialized immune cells in the spinal cord to be more reactive to pain.

“This indicates that there is another dark side of opiates that many people don’t suspect,” said senior author Linda Watkins, a professor in the Department of Psychology and Neuroscience at Boulder. “It shows that trauma, including surgery, in combination with opiates can lead to chronic pain.”

The key points learned in the study were:
●    Rats given a moderate seven-day dose of morphine after surgery experienced post-operative pain three weeks longer than those not given morphine.
●    The longer the rats received morphine, the more prolonged was their pain.
●    Surgery coupled with opioids are a “one-two” hit which creates an enduring state of inflammation that may lead to chronic pain.

A previous study by Watkins and Grace, published in the Proceedings of the National Academy of Sciences in 2016, showed that just a few days of treatment with opiates for peripheral nerve pain, such as sciatica, could exacerbate and prolong pain for months in animals, in part by increasing expression of inflammatory genes.

There have also been a few small studies in humans that associated post-surgical opioid use with chronic pain as much as one year later.

Since an unusually high number of people end up with postoperative chronic pain, it’s no wonder that, according to the National Institutes of Health, more than 50 million U.S. adults experience chronic pain.

Watkins is also studying novel compounds that could be used with opioids to mute the exaggerated immune response they trigger, as well as alternative painkillers, including cannabinoids, for pain.

Of course my favorite “cannabinoid” producer for pain is found in the diet. When the Omega-3 deficiency is addressed and the ratio of essential fats, Omega-6 to Omega-3, is close to 1:1, the body is fully Omega-3 equipped. That’s important because the same type of cannabinoids found in marijuana are also produced naturally in the body from Omega-3 fatty acids. So let’s eat foods that have properly balanced essential fatty acids and avoid those that are not properly balanced. Then maybe we can refuse opioids if we’re injured.

To your health.

Ted Slanker

Ted Slanker has been reporting on the fundamentals of nutritional research in publications, television and radio appearances, and at conferences since 1999. He condenses complex studies into the basics required for health and well-being. His eBook, The Real Diet of Man, is available online.

Don’t miss these links for additional reading:

Can Food Compete with Pills? By Ted Slanker

Opioid Epidemic from Wikipedia

Morphine Paradoxically Prolongs Neuropathic Pain in Rats by Amplifying Spinal Nlrp3 Inflammasome Activation by Peter M. Grace, et.al.

Opioids After Surgery Can, Paradoxically, Prolong Pain by Lisa Marshall University of Colorado Boulder

Opioids Now Kill More People than Breast Cancer from CNN.com

Post-Surgical Opioids Can, Paradoxically, Lead to Chronic Pain

Repeated Morphine Prolongs Postoperative Pain in Male Rats by Peter M. Grace et.al.

Cannabinoid from Wikipedia

Omega-3 Fatty Acids Fight Inflammation via Cannabinoids by Steph Adams, Science Writer

Essential Fatty Acids in Health and Chronic Disease by Dr. Artemis P Simopoulos

Get Your Marijuana Here! by Ted Slanker

Paralyzing Pain by Ted Slanker

Ted Slanker’s Omega-3 Blood Test

Omega-3 Blood Test and use slanker as a code for a discount

Food Analysis: GI, GL, Fat Ratio, Nutrient Load, and Inflammation by Ted Slanker