Study involving 21 pts … produces valid conclusion/outcome ?

lmaoOne Month of Opioid Use Causes Gray Matter Loss, New Study Confirms

http://www.painmedicinenews.com/Science-Technology/Article/03-16/One-Month-of-Opioid-Use-Causes-Gray-Matter-Loss-New-Study-Confirms/35476/ses=ogst

Scientists from the United States and Australia have confirmed there is reduced gray matter volume in several areas of the brains of people who take opioids for more than a few days (Pain Med 2015 Dec 26. [Epub ahead of print]).

The researchers randomly assigned 11 people with low back pain to receive morphine daily for a month and another 10 to receive placebo. Subsequent imaging identified loss of gray matter in several reward- and pain-related regions of the brain in the morphine group but not the placebo group. There were no appreciable gray matter losses in the placebo group despite significant pain reduction.

The changes observed by the investigators corroborate evidence from an earlier study they published that showed alterations in the brain’s reward-related networks after one month of daily morphine use (Pain 2011;152:1803-1810).
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“It’s disturbing to learn that in as little as one month, daily use of opioids can alter brain morphology. And it’s even more disturbing to learn that despite the harm caused to the subjects in the morphine arm, their pain wasn’t any better controlled than the patients receiving placebo,” commented Andrew Kolodny, MD, chief medical officer, Phoenix House; executive director, Physicians for Responsible Opioid Prescribing; and senior scientist, Heller School for Social Policy and Management, Brandeis University, Waltham, Mass. “This is strong evidence that for many patients, the risks of long-term opioids clearly outweigh potential benefit.”

However, lead investigator Joanne C. Lin, PhD, postdoctoral research fellow in the Department of Psychology at the University of Alabama at Birmingham, and her co-investigators from The University of Alabama; Stanford University, in California; and Monash University, in Victoria, Australia, said the study was small and that its clinical implications remain to be seen.

“It is important to note that brain changes do not necessarily mean that something bad has happened. The next step is to carefully monitor patients taking opioids to see what happens when the brain changes,” Dr. Lin said in an email to Pain Medicine News. “Are the brain changes associated with good (e.g., pain relief) or bad (e.g., addiction) outcomes? It is important that we answer that question before we start suggesting that this research should change how physicians treat pain.”

The patients’ average ages were 39 years in the morphine group and 45 years in the placebo group (P=0.178), and the average duration of pain was 11.1 years in the morphine group and 5.2 years in the placebo group (P=0.115). There was a 29.9% reduction in pain in the morphine group over the month of the study and a 33.3% reduction in the placebo group.

Magnetic resonance imaging revealed significantly reduced gray matter with morphine in the left inferior orbitofrontal cortex, right gyrus rectus, bilateral presupplementary motor areas and left dorsal posterior cingulate. There also was significant volume loss in the superficial subregions of the bilateral amygdala, left insula, two regions of the left superior temporal gyrus, right precentral gyrus, right superior frontal gyrus, right inferior temporal gyrus and right rolandic operculum. Several of these overlapped with decreases documented in earlier studies. There also were gray matter volume increases in some areas such as the bilateral insula and right hippocampus. There were no significant volume changes in placebo patients.

“I hope the authors report back on how these patients do over time. It will be important to learn if the brain changes are reversible after opioids are discontinued,” said Dr. Kolodny.

6 Responses

  1. Did they even do a scan on them before this “research” was done, 21 patients, what a waste of time and $$

  2. How on earth did I miss this one? Good grief, I can imagine Kolodny salivating all over this. I wonder if he realizes the Suboxone he prescribes on a regular basis and advocates as the “first line of treatment” for addiction (including the use of it on a long-term basis) is an opioid that causes that same “grey matter.” Tell him to put that in his pipe and smoke it. You know, I could not give a rat’s ass if my brain is full of grey, pink, purple or red matter. All I care about is that my pain is reduced to an adequate level in which I can function, live and have some quality to my life.

  3. It’s disturbing to learn that in as little as one month Kolodny can once again cherry pick “evidence” and convince the general public of his agenda. If that’s not being a quack, I’m not sure what is.

  4. I’m beginning to think Kolodny is related to that Wakefield guy from Britain who made up the whole story on vaccines causing Autism….they’re both quack so called scientists…if they are really even that. I wouldn’t consider them doctors.

  5. In such a small study group:

    1) Are the changers truly due to opioid exposure and therefore there is a causal relationship? Is the relationship just casual as the cause might be related to another etiology, e.g., chronic pain? Are the noted changes the result of a statistical anomaly?…Recall that there were less than 2 dozen people in total involved in this study.

    I sense some sort of deranged confirmation bias here on account of the conclusion stated; the gulf between such a small study, the given observations and the resulting conclusion is Grand Canyon sized, conceptually speaking. Just because there were changes, does that necessitate that the changes were bad? While some areas appeared to shrink, others grew larger. Could this be an adaptation-related change due to the complex relationships between chronic pain and the exposure to an opioid that provides for relief from the chronic pain? If so, does this mean that this is a bad thing? There is so much that is not comprehensively understood about the brain and the relationships between the parts and pieces.

    This is the same kind of mentality that gave rise to the early American colonial period trials and executions of the old, female hermits that lived in the woods and practiced an early form of evidence-based medicine via pharmacognosy. The patriarchal establishment threatened by these women and used the lack of understanding of what they did to brand them as witches. They were arrested, tried unfairly, publicly shamed, tortured and/or executed.

    Lastly, what kinds of tests were administered to produce data that demonstrates that there was a change-related state of harm produced in the opioid group? Pursuant to what I read that is published here, I did not see any sort of assessments done to evaluate what the real world effects were of the reported changes.

    I think that the lead researcher(s) tacit question was, “Do opioids used chronically cause harm to the brain?” Any demonstrable changes could conceivably be interpreted as yes, if one had a preconceived agenda buried within their “hypothesis”, then any changes would give excuse to herald from the rooftops that chronic opioids are bad…very bad. This raises a couple more questions. Does not the researcher(s) know how patently transparent the whole prejudicial scenario based off of this paper is? Is this all intellectually dishonest? Yes, of course.

    Seriously, have the political activists costumed as scientists in their white lab coats become that lazy? They aren’t even trying to hide what their true motives are anymore. To arrive at the conclusion that the researchers stated, based on the overall study design, there is a huge disconnect as I and others have noted. The only thing that I can figure is, is that this paper is aimed for direct consumption by the general public. Still, anyone with an interest in science that paid attention through to the end of their high school career will see the huge gaping holes in this so-called “research”. All I can say at this point is for the reader to note at the upper, right hand area of this page with the meme that features Adolph Hitler; please read the words in the meme. That, dear reader, is what is being perpetrated on us at this point, not only here, but in manifold areas where the State is making attempts at social engineering through prevarication, logical fallacies and all other manner of deception.

  6. Science has proven that chronic pain sufferers who are denied opiates to control their pain experience a severe loss of grey matter in their brains. Unfortunately this loss comes from the bullet hole left in the skull after a pain sufferer can no longer live in severe pain.
    When asked, Government spokesmen say that while they are stumped by this fact they are okay with it because overdose deaths get much more negitive press then suicide deaths. These spokesmen also said that they can and will use these suicides to their benefit by claiming that opiates are the direct cause of death. Now with the public more concerned about overdoses and suicides, they will no longer care about the fact the the DEA failed miserably in stopping the flow of illegal drugs across our borders.

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