I understood that opioids acted on the pain receptors in the brain to kill pain. Am I wrong, or have they just recently discovered they work locally as well?

Add a bit of DMSO to the morphine mix and it will penetrate deeper and faster. DMSO is a very good carrier agent. Down side is the patients breath will smell like garlic and the DMSO has a smell that reminds me of ‘fish tank water’.

Thanks for your post about this very important issue of treatments for chronic pain – a problem of pandemic proportions.

Unfortunately, often drugs and means of pain management are the only options offered to chronic pain sufferers. And now with reports of addiction and abuse being rampant in people suffering from pain, it is clear that we need new, permanent and drug free solutions.

Having discovered a previously unknown source of chronic musculoskeletal pain after almost 40 years of research and clinical practice, I have developed a therapy that permanently eliminates chronic muscle and joint pain without the use of drugs or surgery.

My new book, Forever Free From Chronic Pain discusses not only my discoveries and innovative therapy, but my own experience with chronic pain as well.

The book also discusses why current treatments for chronic neck, hip, knee and back pain aren’t working, how to determine if my innovative therapy will work for a chronic pain sufferer and how, through advanced technology, a person’s body can heal itself for good.

I invite you to sign up for a free chapter and learn more about my book at: http://www.foreverfreefromchronicpain.com.

For those interested in speaking out against the lack of real options for pain sufferers, I invite you to join the group, Citizens for a World Free From Chronic Pain: http://tinyurl.com/CWFCPgroup

Thank you for helping to bring awareness to this chronic pain epidemic and the need for real solutions.

Best wishes,
Prof/Dr Brian A Rothbart

You neglected to mention a topical opioid, fentanyl (Duragesic), which is used extensively in pain management. It is available in transdermal patch and buccal lozenge.While it has some systemic side-effects like oral opioids, it has been a real godsend for patients with chronic pain. I have been a consultant to various hospice organizations and for patients on multiple oral meds, it really cuts down on the amount of pills they have to swallow per day. Also, it tends to cause more side-effects in those with less muscle stores (use cautiously in 80lb elderly)
The topical morphine idea sounds crazy if you ask me-could it be the placebo effect at work?
Mary Scott, RPh, CGP (Certified Geriatric Pharmacist)

Mary,

There is a distinct difference between the fentanyl patch and other agents such as the lidocaine and diclofenac patches. Fentanyl is a transdermal agent, while the others are topical agents. Transdermal means it is absorbed through the skin and taken into the bloodstream to work at a site remote from the application site. This is why one can place a fentanyl patch on the chest for low back pain. Topical agents are only meant to act directly under their application site, and have minimal systemic absorption.

As for topical morphine, I think its has a possibility to work. If you recall, opioids work by suppressing the release of acetylcholine through binding at the presynaptic mu receptors (peripherally), as well as postsynaptic inhibition of descending efferent pathways (centrally). If this formulation can suppress neuronal activity at the surface nociceptors, then I believe the patients would receive some benefits.

Any news on there being larger double-blinded clinical trials for this? It would be interesting to see if there is a placebo effect. It’s probably not if no other treatment worked for this population, but still …

Living in pain is one of the worst feelings a man or woman can have. I think any experimental approaches on any type of pain killer is a wonderful idea. If the industry took further steps for aiding those with chronic pain i truly feel we could be in a better place in the future. The placebo affect may interfere, but as Jason stated, it is quite unlikely.