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- Narcotic enhanced sensitivity: The increased sensitivity from the continuous use of a narcotic. Patients taking narcotic (opioids) on a long term basis, perhaps as little as 4 months, can develop increased sensitivity to pain. Even things like rubbing their shoulders causes a response that is not appropriate to the action. Many times this is not reversible.
- Glial Cells: Cells in the spinal fluid that can be activated by continuous narcotic therapy and subsequently significantly reduce the effectiveness of the narcotic in managing pain. They also cause pain to be felt at a lower level of stimulus.
Example: I have two patients. One is a muscular young male in his 20's and the other a women in her 60's. Both are going to get the same trigger point injections.
The young muscular male is on continuous narcotic therapy. Every injection is accompanied by clenching fists and teeth and groans... He is not having a good day!! Every injection is very very painful for him.
The lady in her 60's receives the same injections with the same medications. She does not flinch or utter a sound.
This is what can happen with continuous narcotic therapy. The worst part is that even when the narcotics are stopped the level of pain that is felt does not change. Currently there is no therapy to reverse the heightened sensitivity to pain.
Now does anyone want to take this risk??
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