Abstract
When people take opioids for long periods of time, they often need higher and higher doses to get relief from pain. This so-called dose escalation increases a patient’s risk of addiction or even overdosing. A research team from Stanford University now reports that the activity of a certain type of sensory neuron drives this phenomenon in mice. The findings suggest that blocking the action of opioids at these neurons could prevent dose escalation (Nat. Med. 2017, DOI: 10.1038/nm.4262). The study proposes a new mechanism for two opioid side effects that are responsible for dose escalation: tolerance, in which a patient becomes less sensitive to a given dose of a drug, and hyperalgesia, in which opioid use paradoxically makes a person more sensitive to pain. The mechanism outlined by Gregory Scherrer and his Stanford team centers on cells called nociceptors, which relay pain signals from the skin and internal organs to
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