US Pharm. 2015;40(3):16-17.

Patients who take opioids on a regular basis can become tolerant, requiring a higher dose for pain relief. In a study published in Anesthesiology, scientists have identified a compound that might play a role in the development of opioid tolerance, and it may be possible to lessen the development of opioid tolerance if that compound is neutralized.

“Opioid tolerance is a growing problem among chronic pain patients and cancer patients in particular,” said Chih-Peng Lin, MD, assistant professor, Department of Anesthesiology, National Taiwan University College of Medicine. “We found that CXCL1, a protein produced by spinal cord tissue, contributes to opioid tolerance. By neutralizing CXCL1 in patients, we might help solve the problem of opioid tolerance.”

The scientists compared patients with cancer-related pain treated by strong opioids such as morphine with age-matched control subjects who did not have cancer and were not taking opioids. They found that in both cancer patients and rats, subjects regularly given opioids and deemed opioid tolerant had an increased concentration of CXCL1 compared with those not regularly administered opioids.