Pain treatment is stupid and bad in a number of ways.
A major reason behind the opioid epidemic is that OxyContin is supposed to give 12 hours of pain relief but it doesn’t actually last that long. Being chronically slightly short of pain medication and suffering withdrawal symptoms is a great way to get addicted.
Opioids don’t actually work on neuropathic pain; they target a totally different pain receptor. Nerve pain is qualitatively different and is sensed by the cannabinoid receptors. And, yet, we don’t have a whole suite of drugs to target the cannabinoid receptors. We just have cannabis, which is illegal in a lot of states. (As a stopgap, cannabidiol is a cannabis compound that helps with chronic pain, is non-psychoactive, and legal.)
“Functional” chronic pain conditions where there’s no visible injury, like fibromyalgia or chronic fatigue syndrome or back pain with a central sensitization component, are very hard to treat and are stigmatized as “all in the patient’s head”, whereas there are a fair number of studies showing that people with these conditions look different hormonally, immunologically, and/or neurologically from healthy people. The standard treatment for CFS for a long time was a graded exercise program which has now been shown to have no evidence of efficacy.
If I were in charge of pain research, I’d study a much wider range of drugs in animals, including new drug classes.
If I had a chronic pain condition, I’d definitely expect self-experimentation and doing my own research to be more useful here than with other diseases, because there’s biases in the medical system (against drug use and disabled people) and a lot of variation between individuals.
Pain treatment is stupid and bad in a number of ways.
A major reason behind the opioid epidemic is that OxyContin is supposed to give 12 hours of pain relief but it doesn’t actually last that long. Being chronically slightly short of pain medication and suffering withdrawal symptoms is a great way to get addicted.
Opioids don’t actually work on neuropathic pain; they target a totally different pain receptor. Nerve pain is qualitatively different and is sensed by the cannabinoid receptors. And, yet, we don’t have a whole suite of drugs to target the cannabinoid receptors. We just have cannabis, which is illegal in a lot of states. (As a stopgap, cannabidiol is a cannabis compound that helps with chronic pain, is non-psychoactive, and legal.)
“Functional” chronic pain conditions where there’s no visible injury, like fibromyalgia or chronic fatigue syndrome or back pain with a central sensitization component, are very hard to treat and are stigmatized as “all in the patient’s head”, whereas there are a fair number of studies showing that people with these conditions look different hormonally, immunologically, and/or neurologically from healthy people. The standard treatment for CFS for a long time was a graded exercise program which has now been shown to have no evidence of efficacy.
If I were in charge of pain research, I’d study a much wider range of drugs in animals, including new drug classes.
If I had a chronic pain condition, I’d definitely expect self-experimentation and doing my own research to be more useful here than with other diseases, because there’s biases in the medical system (against drug use and disabled people) and a lot of variation between individuals.