Study Suggests New Way to Treat Orofacial Pain Without Opioids

A low dose of the semisynthetic drug naltrexone has been found to provide pain relief for patients with orofacial and chronic pain, and without risk of addiction, a new study reports. The paper, “Use of Low-Dose Naltrexone in the Management of Chronic Pain Conditions,” was published in the Journal of the American Dental Association. The University of Michigan (U-M) School of Dentistry study examined if naltrexone—an oral alternative to naloxone, the nasal spray used to reverse opioid drug overdoses—is a good option for pain management when prescribed in low doses. Naltrexone, a semisynthetic opioid that has been used off-label to treat chronic pain, blocks the effects of alcohol and opioids when prescribed in doses of 50 mg to 100 mg.

Elizabeth Hatfield, DDS, a clinical lecturer in the Department of Oral and Maxillofacial Surgery and Hospital Dentistry at the U-M School of Dentistry, and her team conducted a systematic review of the literature and found “a reduction in pain intensity and improvement in quality of life, plus a reduction in opioid use among patients with chronic pain” with this approach.

Investigators found low doses of naltrexone (0.1 mg to 4.5 mg) target glial cells to reduce pain and sensitivity of the nervous system. The drug’s ability to address pain and not just mask it allows researchers to better target diseases that cause chronic pain. Studies suggest low doses of naltrexone are best used on centralized pain disorders, such as temporomandibular joint disorders.