Observational Analgesia Mechanisms for Pain Management
Trial Summary
What is the purpose of this trial?
Placebo effects held an ambivalent place in health care for at least two centuries. On the one hand, placebos are traditionally used as controls in clinical trials to correct for biases and the placebo response is viewed as an effect to be factored out in order to isolate and accurately measure the effects of the treatment. On the other hand, there is scientific evidence that placebo effects represent fascinating psychoneurobiological events involving the contribution of distinct central nervous as well as peripheral physiological mechanisms that influence pain perception and clinical pain symptoms and substantially modulate the response to pain therapeutics. Therefore, placebo effects have shifted from being a challenge for clinical trials to a resource to trigger the reduction of pain based on endogenous mechanisms that can be activated in the brain to promote hypolagesia, self-healing, and well-being. This is relevant in acute pain settings given that chronic opioid users die within approximately 2.5 years of being prescribed their first opioid medication to treat acute pain. The overall hypothesis is that observational learning influences neural pain modulation and cognition systems, including processes associated with mentalizing (the ability to cognitively understand mental states of others), empathy (the ability to share an emotional experience), and expectancy (the anticipation of a benefit). The objective is to determine the brain mechanisms of observationally-induced analgesia using brain mapping approaches that target changes in blood oxygenation and oscillatory activity in the brain, thus enabling investigators to draw inferences about the localization and extent of neurobiological activation underlying hypoalgesia driven by observation. Therefore, the investigators designed innovative experiments using pharmacological fMRI, EEG, and combined EEG-fMRI measurements.
Do I need to stop taking my current medications to join the trial?
Yes, you will need to stop taking certain medications, such as antidepressants, ADHD medication, non-over-the-counter painkillers, methadone, benzodiazepines, barbiturates, and narcotics, if you have used them in the past 3 months.
What data supports the effectiveness of the drug for pain management?
Is the treatment generally safe for humans?
The combination of buprenorphine and naloxone, used in treatments like Suboxone, is generally considered safe with a favorable safety profile compared to other opioids. It has less risk of causing severe breathing problems, and studies suggest it is relatively safe even in cases of overdose, with most symptoms being mild and manageable.56789
How is the drug Naloxone unique for pain management?
Eligibility Criteria
This trial is for English-speaking adults aged 18-55 without chronic pain, severe psychiatric conditions, or recent hospitalization for mental health issues. Participants must not be pregnant, color-blind, left-handed, have metal implants incompatible with MRI scans, a history of substance abuse or use certain medications recently.Inclusion Criteria
Exclusion Criteria
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo fMRI and EEG measurements with naloxone or saline administration to study neural mechanisms of observationally-induced hypoalgesia
Follow-up
Participants are monitored for safety and effectiveness after treatment
Treatment Details
Interventions
- Naloxone (Opioid Antagonist)
- Saline (Other)
Naloxone is already approved in United States, European Union, Canada for the following indications:
- Opioid overdose reversal
- Opioid overdose reversal
- Opioid overdose reversal