Thursday, 18 August 2016

Transdermal Buprenorphine: A Safe Option For Nerve Pain?

Today's post from (see link below) is once again aimed at diabetics with neuropathy but applies to all those suffering from neuropathic pain. At first it seems promising, in these days of opioid hysteria. It suggests that a new opiate medication called transdermal buprenorphine, (a patch for the skin) can reduce neuropathic pain. However, if you look carefully at the study results, the numbers are so small as to hardly prove anything. It's good to see someone sensibly promoting the benefits of opioids to those living with chronic pain, especially when the rest of the media seems set on dismissing them as threats to the moral fibre of all nations but in this case, it may be advisable to wait until many more study results are released, over much wider and larger study groups, before getting too excited. Certainly worth remembering for the future and maybe later discussing with your neurologist.

Opioid medication shown to be effective on painful diabetic neuropathy
 Benedict Jephcote Fri, 22 Jul 2016

A type of opioid medication can ease the effects of pain as a result of diabetic neuropathy (nerve damage), a study has found.

A research team in Australia say the opioid pain medication, can help people who have moderate to severe diabetic peripheral neuropathic pain (DPNP).

DPNP is the name given to nerve damage which is caused by high blood sugar over a number of years and is one of the most common complications associated with diabetes. If left untreated it can lead to numbness, loss of sensation, and sometimes pain in feet, legs, or hands.

The study involved 186 people with type 1 or type 2 diabetes and stable glycemic control, who had been experiencing DPNP for at least six months.

They were split into two groups and were randomly given buprenorphine or placebo patches. Their pain levels and other symptoms of DPNP were logged in a daily patient diary and during clinic visits.

A high number of participants did not complete the trial, with 56 in the buprenorphine group dropping out and 69 people who were using the placebos.

Researchers said nausea and vomiting were the main reasons for early withdrawal in those who were testing the medication.

For those who remained, 86.3 per cent of the buprenorphine group experienced a 30 per cent reduction in pain after 12 weeks. By comparison, 56.6 per cent of the placebo group experienced this level of pain reduction.

The researchers wrote: "Transdermal buprenorphine, when tolerated, is an effective therapy for DPNP and provides another option to manage this challenging painful condition.

"Nausea and constipation need to be managed proactively to optimise treatment outcomes."

The study was led by Dr Richard W Simpson from Box Hill Hospital and Dr John H Wlodarczyk from Consulting Services in New Lambton, New South Wales, Australia. The study was published in the Diabetes Care journal and was supported by the manufacturers of the buprenorphine patch, Mundipharma.

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