Your body makes its own morphine. It’s true. Substances in your body called endorphins, enkephalins and dynorphins work on the same receptor as morphine. You have probably heard of a runner’s high. This results from a flood of endorphins that stimulate the morphine receptors.
When morphine or another opioid is given to a person, it acts on an area of the brain called the hypothalamus to inhibit the release of many hormones including beta endorphin. The endorphins can also inhibit their own release resulting in increased pain, allodynia or hyperalgesia. It is called a negative feedback loop.
Recently, there has been a flood of research examining the use of a drug called naltrexone in low doses (Low Dose Naltrexone or LDN) to treat pain. Naltrexone blocks the effects of the opioid receptors and has been used to treat alcohol and opioid addiction. When naltrexone blocks the endorphin response in the hypothalamus, it actually stimulates the body to produce more endorphins. LDN has been proven, through scientific study, to actually increase the levels of circulating endorphins. The theory is that, by increasing the body’s own circulating endorphin levels, the endogenous opioids will produce more inhibition at the body’s own pain receptors.
Typical doses of LDN are 0.5 to 4.5mg per day. Because of rhythms of the body’s production of master hormones, LDN is best taken between 9:00 pm & 3:00 a.m. Most patients take it at bedtime.
The only major side effect seen in most of the patients is sleep disturbances Because of this, I recommend gradually titrating the dose up to 4.5mg. This can be accomplished by taking 1.5mg by mouth at bedtime for one to two weeks, then 3mg at bedtime for one to two week, followed by 4.5mg at bedtime thereafter.
If the patient is already on an opioid for pain such as morphine, codeine or hydrocodone, they should consult the prescribing physician to ensure there will not be a precipitated withdrawal from the narcotics when LDN is added to their regimen. However, it is possible to use LDN concurrently with narcotic analgesics. There are many case studies demonstrating that concurrent use of LDN with narcotics decreases the amount of narcotics the patient needs for pain control.