{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:30:04Z","timestamp":1791905404967,"version":"4.3.4"},"reference-count":0,"publisher":"Weston Medical Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Ultra low doses of opioid antagonists such as naloxone block excitatory opioid receptor pathways may paradoxically enhance morphine analgesia. This case study reports safety and efficacy of ultra low-dose intrathecal (IT) naloxone added to IT morphine for the treatment of severe refractory chronic low back pain. A 56-year-old man with a history of severe chronic low back pain (postlaminectomy syndrome) was evaluated. Extensive multidisciplinary therapies had all failed. Initial treatment at our clinic was a lumbar IT trial of morphine (unsuccessful) up to 50 mg\/day. We administered an IT bolus of morphine 2 mg combined with IT naloxone of 20 ng with the patient\u2019s consent and approval. The onset of pain relief was within 20 minutes and peaked at 1 hour with a 50 percent reduction in VAS pain score. There were no signs of adverse drug toxicity or hemodynamic compromise. An IT infusion of daily morphine 5 mg and naloxone 50 ng was started. Throughout the 3-year follow-up period, the patient maintained pain reduction of 60 to 80 percent, with a return to daily activities and no further hospitalizations.<\/jats:p>","DOI":"10.5055\/jom.2008.0028","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T17:00:42Z","timestamp":1517590842000},"page":"251-254","source":"Crossref","is-referenced-by-count":18,"title":["Low-dose intrathecal naloxone to enhance intrathecal morphine analgesia: A case report"],"prefix":"10.5055","volume":"4","author":[{"given":"Scott","family":"Hamann, MD, PhD","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Alexander","family":"Sloan, MD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Witt, MD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3008","published-online":{"date-parts":[[2018,1,30]]},"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/992\/1002","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/992\/1002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T15:24:48Z","timestamp":1683645888000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,30]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2008,7,1]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.2008.0028","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"value":"1551-7489","type":"electronic"},{"value":"1551-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2018,1,30]]}}}