Participants needed for UBC study into opioid treatment to help painful spinal cord injuries
Credit to Author: Denise Ryan| Date: Sun, 19 Jan 2020 23:04:33 +0000
Dr. Andrei Krassioukov, a professor of medicine at the University of B.C. and a physician at the GF Strong Rehabilitation Centre in Vancouver, is looking for study participants for a protocol that will help reduce the side-effects among patients with spinal-cord injuries who need opioids to manage severe pain.
The study will examine the effectiveness of a drug called Targin among individuals with spinal-cord injuries. Targin contains both oxycodone and naloxone, and is already in use among the non-spinal-cord-injured population. Naloxone is an opioid agonist, and when used in combination with oxycodone, it can block the paralytic effects that the opioid has on the gut and reduce the severe constipation that is a side-effect of opioids.
Krassioukov, a specialist in complications that occur after serious spinal-cord injury, including paralysis, blood pressure, circulation, bladder management, bowel dysfunctions and pain management, said: “Due to the spinal-cord injury patients can have changes to bowel movements due to nerve damage. Many rely on opioids for pain management.”
The combination of spinal-cord injury and opioid use can make normal protocols involving diet and laxatives insufficient to provide relief, and some with spinal-cord injuries spend between 30 minutes and two hours a day managing the issue. Not only does chronic constipation decrease quality of life, it can be life-threatening for people with traumatic spinal-cord injuries, said Krassioukov.
“Constipation is not good for our health in general and with spinal-cord injury it’s a double-jeopardy,” said Krassioukov. “If there is no bowel movement for two, three days they could develop profound episodes of autonomic dysreflexia, a condition caused by a significant hypertensive crisis with elevated blood pressure, and they can develop stroke and die.”
One of the challenges for physicians, said Krassioukov, is that many are afraid to prescribe opioids even when appropriate.
“We were very scared with the fentanyl crisis but we still understand that for many people who suffer from chronic severe pain from medical issues, opioids are the best way to manage the pain,” he said.
Krassioukov has launched the study with three patients, and is looking for up to 20 participants, male or female. Volunteers must be between 18 and 65 years of age, have had a traumatic spinal-cord injury for more than three months, have been taking a physician-prescribed opioid for at least three months and must be a Canadian citizen and live in the Vancouver area.
Those interested in volunteering can contact Krassioukov through ICORD (International Collaboration on Repair Discoveries) at Vancouver General Hospital, https://icord.org/