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The Use of Conditioning Open-Label Placebo in Opioid Dose Reduction: A Case Report and Literature Review.

作者信息

Estudillo-Guerra Maria A, Mesia-Toledo Ines, Schneider Jeffrey C, Morales-Quezada Leon

机构信息

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States.

出版信息

Front Pain Res (Lausanne). 2021 Jul 12;2:697475. doi: 10.3389/fpain.2021.697475. eCollection 2021.


DOI:10.3389/fpain.2021.697475
PMID:35295534
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8915754/
Abstract

Adequate pain management for inpatients in rehabilitation units is essential for achieving therapeutic goals. Opioid treatments are commonly prescribed, but these are associated with numerous adverse effects, including the risk of addiction and decreased quality of life. Conditioning an open-label placebo is a promising approach to extend the analgesic effect of the opioid while reducing its overall dosage. To describe a patient's experience in using conditioning open-label placebo (COLP) as a pharmaco-behavioral intervention to decrease opioid intake and its side effects after inpatient rehabilitation discharge, and to perform a literature review about the use of open-label placebo in pain. This case study has been extracted from a clinical trial initiated in 2018. A 61-year-old male was recruited at a tertiary rehabilitation hospital after suffering a traumatic sport-related injury and orthopedic surgery. Pain management included prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and short-acting oxycodone. After trial participation, the patient requested off-label COLP treatment to help him decrease outpatient opioid utilization. After COLP treatment, the patient could discontinue oxycodone intake (a reduction from 15 morphine equivalents/day) after rehabilitation discharge. Moreover, opioid side effects decreased from 46 to 9 points on the numerical opioid side-effects scale. A literature review identified five clinical trials using "honest" open-label placebo (OLP) or COLP as an experimental intervention for pain control. From these studies, two were in the area of chronic lower back pain, one in post spine surgery, one in irritable bowel syndrome, and another in spinal cord injury and polytrauma. Four studies reported positive outcomes related to pain control, while one study showed no significant differences in pain management between treatment-as-usual and the COLP group. The case report illustrates how a pharmaco-behavioral intervention can facilitate downward opioid titration safely after inpatient rehabilitation. It initiates a discussion about new approaches for opioid management using conditioning and the patient's expectation of pain relief.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb2/8915754/450360260ba5/fpain-02-697475-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb2/8915754/52fb10bc7025/fpain-02-697475-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb2/8915754/450360260ba5/fpain-02-697475-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb2/8915754/52fb10bc7025/fpain-02-697475-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb2/8915754/450360260ba5/fpain-02-697475-g0002.jpg

相似文献

[1]
The Use of Conditioning Open-Label Placebo in Opioid Dose Reduction: A Case Report and Literature Review.

Front Pain Res (Lausanne). 2021-7-12

[2]
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[3]
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[4]
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[5]

2005-12

[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
A systematic qualitative review of ethical issues in open label placebo in published research.

Sci Rep. 2025-4-10

本文引用的文献

[1]
Conditioned open-label placebo for opioid reduction after spine surgery: a randomized controlled trial.

Pain. 2021-6-1

[2]
Conditioning open-label placebo: a pilot pharmacobehavioral approach for opioid dose reduction and pain control.

Pain Rep. 2020-7-20

[3]
Effects of open-label placebo on pain, functional disability, and spine mobility in patients with chronic back pain: a randomized controlled trial.

Pain. 2019-12

[4]
Open-Label Placebo: Reflections on a Research Agenda.

Perspect Biol Med. 2018

[5]
Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

BMJ. 2018-10-2

[6]
"Are perioperative opioids obsolete?" Proceedings of an IASP Acute Pain Special Interest Group Satellite Symposium September 25, 2016 Yokohama, Japan.

Pain Rep. 2017-7-10

[7]
How Classical Conditioning Shapes Placebo Analgesia: Hidden versus Open Conditioning.

Pain Med. 2018-6-1

[8]
Open-label placebo treatment in chronic low back pain: a randomized controlled trial.

Pain. 2016-12

[9]
Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use.

J Gen Intern Med. 2016-5

[10]
Placebo Effects in Medicine.

N Engl J Med. 2015-7-2

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