Opioids and Cannabinoids

After trying multiple pharmacological and non-pharmacological treatment modalities for his pain, Mr. A.H.’s participation in therapies continues to be limited by ongoing shoulder and neck pain. He is now willing to consider any medications that may offer relief, as he is very motivated to participate in his rehabilitation and achieve his goals before being discharged home.
Q17. What is the evidence for the use of opioids or cannabinoids for post-SCI neurogenic pain?
1. Intravenous morphine reduces mechanical allodynia (level 1 evidence).
2. Tramadol reduces neuropathic pain (level 1 evidence).
3. Alfentanil reduces chronic, overall pain post SCI (level 1 evidence).
4. Alfentanil is more effective in reducing wind up like pain post SCI than ketamine (level 1 evidence).
5. Cannabinoids are a potential new treatment for post-SCI pain in need of further study.
For more information please see: Opioids for Post-SCI Painand Cannabinoids in Post-SCI Pain