Low-dose naltrexone is a promising potential treatment for patients with chronic pain conditions, the findings of a systematic review have indicated (1 December 2020).
Researchers reviewed data from eight studies (four case reports, three clinical studies and one randomised controlled trial) and found a reduction in pain intensity and improvement in quality of life for patients treated with low-dose naltrexone for chronic pain. There was also a reduction in opioid use among these patients.
At low doses, naltrexone — developed as an oral alternative to naloxone to reverse opioid drug overdoses — has anti-inflammatory, immunomodulatory and antinociceptive capabilities. As such, it is used off-label to treat chronic pain, but there are few randomised controlled studies to support this.
“Low-dose naltrexone begins to address the cause of pain and not just mask it, which allows us to better target diseases causing chronic pain, as well as potentially consider pain control outside of opioid use,” said Elizabeth Hatfield, a clinical lecturer at the University of Michigan and lead author on the study.
The researchers concluded that more large-scale studies were needed to investigate the efficacy of low-dose naltrexone and determine its potential applications.
- 1Hatfield E, Phillips K, Swidan S, et al. Use of low-dose naltrexone in the management of chronic pain conditions. The Journal of the American Dental Association 2020;151:891-902.e1. doi:10.1016/j.adaj.2020.08.019