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Free drugs, anyone???

My apologies for being blatantly obvious in trying to catch your attention, but I am actually telling the truth when I say that we all have a drug cabinet in our brain - and it's full of powerful analgesics that are free to access, 24/7! Want to know more? Then read on:

I was unfortunate enough to rupture my ACL playing netball several years ago. It was the most painful injury I have EVER had, but after making a fool of myself rolling around on the ground and swearing like a trooper (profanity and pain - now that's a topic for another blog), my knee eventually stopped hurting. Weirdly, though, when I went to watch my team play the following Saturday, my knee started to really hurt again. I actually found it really hard to stay and watch people run and jump and land, knowing that that was how I had hurt myself one week earlier.

So the initial pain makes sense - my knee was damaged and it was not safe for me to keep playing on it, my brain analysed the information and produced pain to tell me my game was over!

But why did my knee that was feeling okay when the original 'danger' had passed suddenly start to hurt again?

Well, there's a bit of "amazing brain" stuff going on here.

The answer lies in understanding the brain and how it responds as it receives all the information at hand plus information from inside the brain (including memory, thought, planning).

Your drug cabinet is made up of millions of brain cells and connections. These connections link multiple areas of the brain together, so that thoughts, planning, memory and emotion all change your pain. Your drug cabinet makes a natural cocktail that dampens down incoming "danger" messages. You have probably accessed these before - ever noticed a bruise that you don't remember getting? Perhaps it happened while you were out having fun, so at the time the danger messages were completely dampened out by all the good stuff going on at the time - the good stuff would have meant the drug cabinet was well and truly open.

So just what is in this cocktail?

You may have heard of some of the ingredients, like serotonin, enkephalin and dopamine, but did you know that we also produce opioids and other morphine-like substances!! And they are even more effective than the synthetic stuff the pharmacists are selling! We hear examples of the power of these drugs in stories where people have done remarkable things when they should have been in pain. In these moments the brain does not produce pain, and the drugs released from the drug cabinet are pivotal in stopping those danger messages reaching the brain.

These drugs are free and available at any time UNLESS the drug cabinet shuts up shop for a while - this happens for many reasons, but could include being in a place that worries you (ie: me watching netball) or when you think you might have to do something that will hurt, or even when you are just in a pretty foul mood.

If the drug cabinet shuts up, then the danger messages coming from the body get louder (no damping down happening). A group of pain researchers liken this to being responsive to our relative "safety" or "danger". The safer we feel, the more open the cabinet is and the more danger we feel, the more closed it becomes.

So can we control this drug cabinet?

Yes, we can seek out the safety! This means that we can do as many things as we can think of to "de-threaten" the situation, and put the balance back into our drug-releasing favour. The network of connections that we talked about earlier is dictating whether the cabinet opens or closes (as it decides whether it is worth you having pain - or not) so filling this network with information that says "this is not as dangerous as it seems" can help the drug cabinet to be opened and the 'danger' messages can be dampened.

Implications for those with persistent pain.

If you are "stuck" with some pain that hasn't gone away in the time-frame that you would expect, there are lots of things you could do to open up that cabinet again, and get some effective and free pain relief.

You could learn more about your pain, spend time preparing for threatening situations so they are "de-threatened", set some achievable goals or work with a Health Professional that listens and considers the whole picture, and not just your sore body. Even unrelated things, like seeking out fun stuff, can help present a "safer" message to the brain.

As some wise Pain Researchers once said:

"...the key to the cabinet is ultimately in your hands".

from "Explain Pain Supercharged", by Lorimer Moseley and David Butler

You can hear David Butler speak on this very topic right here.


This blog is based on the pain novella "The Drug Cabinet in the brain", from page 203 in "Ex