“You are too powerful for pills”
The successes of medication for inflammatory pain do not translate over to chronic pain, especially pain where there is no intervening disease. Ten people with chronic pain may have to take medication before one gets any significant effect. This lack of response is increasingly understood as immunological. Activated glial cells in the brain disrupt opioid efficacy thus contributing to opioid tolerance and dependence. Essentially the patient has to take a higher and higher doses for efficacy, thus risking side effects. The work of Linda Watkins and Mark Hutchinson are worthwhile reading.
Framed another way – if a person’s brain constructs that there are enough dangers and threats within themselves and society, worthwhile of increasing sensitivity, then a defence against synthetic medication may be mounted. In a biopsychosocial framework, maybe the meds would work better if other drivers of increased sensitivity were dealt with or maybe the meds may not even be needed.
This nugget can turn a clinical negative (medication failure) into a positive outlook
Neuroscience nuggets are information nuggets – pieces of biological information based on statement or metaphor that can be used as educational analgesia, explicit education or part of overall story telling. We have collected over 100 of these for a book and will release one or two a week with a short description and references if appropriate.
Explain Pain 2nd Ed, the Graded Motor Imagery Handbook and all noigroup courses are all bursting at the seams with the latest and greatest neuroscience nuggets; click on the links to get your hands on a copy or to find a course near you