Future Biologics, Lawrenceville, GA 30043, USA.
Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel.
Int J Environ Res Public Health. 2022 Jan 4;19(1):552. doi: 10.3390/ijerph19010552.
In the United States, amid the opioid overdose epidemic, nonaddicting/nonpharmacological proven strategies are available to treat pain and manage chronic pain effectively without opioids. Evidence supporting the long-term use of opioids for pain is lacking, as is the will to alter the drug-embracing culture in American chronic pain management. Some pain clinicians seem to prefer classical analgesic agents that promote unwanted tolerance to analgesics and subsequent biological induction of the "addictive brain". Reward genes play a vital part in modulation of nociception and adaptations in the dopaminergic circuitry. They may affect various sensory and affective components of the chronic pain syndromes. The Genetic Addiction Risk Severity (GARS) test coupled with the H-Wave at entry in pain clinics could attenuate pain and help prevent addiction. The GARS test results identify high-risk for both drug and alcohol, and H-Wave can be initiated to treat pain instead of opioids. The utilization of H-Wave to aid in pain reduction and mitigation of hedonic addictive behaviors is recommended, notwithstanding required randomized control studies. This frontline approach would reduce the possibility of long-term neurobiological deficits and fatalities associated with potent opioid analgesics.
在美国，在阿片类药物过量流行的情况下，有非成瘾/非药物的经过验证的策略可用于治疗疼痛和有效管理慢性疼痛，而无需使用阿片类药物。缺乏支持长期使用阿片类药物治疗疼痛的证据，也缺乏改变美国慢性疼痛管理中药物治疗文化的意愿。一些疼痛临床医生似乎更喜欢使用经典的镇痛剂，这些药物会导致对镇痛药的不必要的耐受，并随后导致“成瘾大脑”的生物学诱导。奖励基因在调节伤害感受和多巴胺能回路的适应中起着至关重要的作用。它们可能会影响慢性疼痛综合征的各种感觉和情感成分。在疼痛诊所就诊时，将遗传成瘾风险严重程度 (GARS) 测试与 H-Wave 相结合，可以减轻疼痛并帮助预防成瘾。GARS 测试结果确定了对药物和酒精的高风险，并且可以启动 H-Wave 来治疗疼痛而不是阿片类药物。建议利用 H-Wave 来帮助减轻疼痛和减轻享乐性成瘾行为，尽管需要进行随机对照研究。这种前沿方法将减少与强效阿片类镇痛药相关的长期神经生物学缺陷和死亡的可能性。
