TY  - JOUR
PY  - 2017//
TI  - Endogenous opioid function and responses to morphine: the moderating effects of anger expressiveness
JO  - Journal of Pain
A1  - Burns, John W.
A1  - Bruehl, Stephen
A1  - France, Christopher R.
A1  - Schuster, Erik
A1  - Orlowska, Daria
A1  - Chont, Melissa
A1  - Gupta, Rajnish K.
A1  - Buvanendran, Asokumar
SP  - 923
EP  - 932
VL  - 18
IS  - 8
N2  - Long-term use of opioid analgesics may be ineffective or associated with significant negative side effects for some people. At present, there is no sound method of identifying optimal opioid candidates. Individuals with chronic low back pain (n=89) and healthy controls (n=102) underwent ischemic pain induction under placebo, opioid blockade (naloxone), and morphine in counterbalanced order. They completed the Spielberger Anger-out subscale. Endogenous opioid function x anger-out x pain status (chronic pain; healthy control) interactions were tested for morphine responses to ischemic threshold, tolerance and pain intensity (McGill Sensory and Affective subscales) and side effects. For individuals with chronic pain and healthy controls, those with low endogenous opioid function and low anger-out scores exhibited the largest morphine analgesic responses, whereas those with high anger-out and low endogenous opioid function showed relatively weaker morphine analgesic responses. Further, individuals with chronic pain with low endogenous opioid function and low anger-out scores also reported the fewest negative effects to morphine, whereas those with low endogenous opioid function and high anger-out reported the most. <br><br>FINDINGS point toward individuals with chronic pain who may strike a favorable balance of good analgesia with few side effects, as well as those who have an unfavorable balance of poor analgesia and many side effects. PERSPECTIVE: We sought to identify optimal candidates for opioid pain management. Low back pain patients who express anger and also have deficient endogenous opioid function may be poor candidates for opioid therapy. In contrast, low back patients who tend not to express anger and who also have deficient endogenous opioid function may make optimal candidates for opioid therapy.<br><br>Copyright © 2017. Published by Elsevier Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 1526-5900
UR  - http://dx.doi.org/10.1016/j.jpain.2017.02.439
ID  - ref1
ER  -