The article speaks about using this as a way to escape addiction to painkillers. Not so fast.
Addiction is a phenomenon that predominantly happens in the brain, due to it constantly adapting to find homeostasis. And being unable to perceive pain when you should be is not homeostasis.
> What’s especially neat is that the stimulated brain region normally doesn’t generate any sense of euphoria, the downfall of opioids. This means it’s likely to decrease the chance of addiction. And because the system only stimulates the brain when it detects pain signals, it lowers the chance the brain adapts to the stimulation.
Opioid addiction is not like other addiction mechanisms. After prolonged use the gastrointestinal system is ravaged and when people want to stop they find themselves plagued not only with withdrawals symptoms but also by incredible abdominal pain, so they take more opioids, which worsens the pain, which requires more opioids to alleviate , which worsens the gastrointestinal damage and subsequent pain, and so on...
It's a vicious circle called narcotic bowel syndrome, taking away the pain would go a long way to solving this issue.
I imagine it varies depending on the drug, the patient and the dosage. I was recently on heavy doses of morphine for 10 days and was left unable to eat normally for 4 months afterward, so it can happen quite quick.
But the point is, whether you're addicted or not, you cannot stop taking the drug. If you stop alcohol or smoking you might experience light to severe withdrawal symptoms depending on your level of use, even hospitalization. With opioids you will experiences months of crippling pain and inability to eat normally with the only remedy being more opioids. And you might not even know it's the opioids doing it because the doctors give that garbage out like candy and don't warn you about these side effects.
Just wanted to say THANK YOU for pointing this syndrome out to me. I'm almost sure I have this after years of being prescribed Tramadol for chronic abdominal pain that only ever gets worse. At first it was a life changer. Am now on the max prescribed dose, and the progression of pain seems to only accelerate each time I've upped the dose.
Tramadol is absolute garbage, I feel for you. I was recommended Zofran to help with the nausea and upset by people who went through the same thing but haven't tried it myself.
If you manage to stop, be strong and persevere, it took me months after fully stopping for the pain to go away and to be able to eat normal foods again. My doctor had me do a few purges and I only ate small portions of rice for those months, anything else would make me sick. I was also recommended replacement shakes but haven't tried them.
Best of luck.
I always feel so confused by--and skeptical of--these kinds of brain implant technologies.
It says: "The chip then automatically triggers a light beam to stimulate the region, activating neurons that can override pain signals."
Isn't that potentially stimulating millions or even hundreds of millions of neurons? We don't know what each individual neuron is doing. How is it possible to do this without causing bizarre malfunctions of the brain at best, or completely lobotomizing someone at worst?
It sounds like they depend on the smoke test, doesn't it? Despite the huge advancements in biological sciences, when I get interested in something and read about it I would encounter the "We don't know why exactly it works but it works" much more often than I am used to. It feels so wrong.
> Life follows a simple set of heuristics with an extensive set of exceptions.
And that's OK: heuristics allow a person to intuit some high-level behavior without having to derive it from the lower-level rules (laws). It's readily admitted that the heuristic isn't 100% accurate, and when it's inaccurate you fall back to that explicit derivation process.
From the outsider view of biology, there appear to be many heuristics for which we don't know how to derive from the underlying laws. Chemistry, at various points in time, has had similar issues, but over time we've expanded the amount of things we can derive from underlying physics. Biology, I hope, will follow in time.
The brain is far more robust than often assumed. Read up on Anatoli Bugorski for example. He had rather significant brain damage yet there was virtually no damage to his intellectual capacity. He did suffer from seizures after the accident, but that’s about it.
These kinds of implants have serious risks including infections etc, but for people with long term chronic pain there are few options.
I've seen a few instances where pain management becomes the overall deciding factor in peoples' day to day life.
"I can't go to work and feed my family because everything hurts so bad" can become a common statement for these people.
In addition, addiction to painkillers, spending a huge percentage of your income at compounding pharmacies, and turning to illegal and possibly dangerous drugs to save a buck or to fill the gap between your needs and the insurance companies' coverage are all issues that a non-chemical pain management system like this could solve.
I'm sure it's dangerous and weird to toy with your brain but for many people in America alone the risk would be more than worth the reward.
The DEA tried to ban it a few years ago but too many cancer patients testified before Congress how well it worked compared to the prescription opioids. The DEA was forced to bow out.
The cool thing about Mitragyna speciosa is that it's a tree, a pretty hardy one. In my experience, the older trees have more potent leaves, but ideally, one could plant this tree in their backyard and never have to worry about being dependent on outside help for their pain ever again. You just dry the leaves and make tea from them.
It's just Kratom. It's basically a low level heroin. It's addictive and not really a walk in the park and detoxing from it is very bad. Google Kratom Withdrawal.
It also fucks your kidneys, in a pretty short time of chronic use.
It doesn't cause constipation like the prescription opioids. It's a partial agonist, so it does not build up tolerance and continues to work at the same dose for extended periods of time. It's all natural and a green leafy vegetable, so it's a good source of micronutrients. It is a better pain reliever, more similar to Tramadol/Tapentadol (partial norepinephrine agonists) than the other opioids. Tramadol is too weak and has a max dosage that is quite low. Tapentadol is extremely expensive and not covered by all insurances.
Mitragyna is affordable, shelf safe, and sustainable. It's a silver bullet compared to the unsustainable lifestyle that chronic pain doctors are pumping out with their prescription pads. What other questions do you have?
Wow, smear campaign much?
I don't know of anyone who ever injected this plant or did sexual favors for it. What about it makes you compare it to Heroin, one of the most addictive and elicit narcotics on the planet?
I've been taking Mitragyna for years and have no kidney issues. My kidney function is checked regularly and my GFR and BUN ratios are fine.
Secondly, any drug, even antidepressants, have some form of dependency. The withdrawal from Mitragyna isn't bad. With a simple taper, one can easily get off of it. I've done so myself a couple times. Google oxycodone withdrawal, Xanax withdrawal, Lexapro withdrawal..ad infinitum. Most controlled prescription drugs have far worse withdrawals.
Here's one bit of truth I'll agree with: buying Mitragyna from gas stations or head shops is a terrible way to acquire it. And these sources may be impure or tainted and cause health issues. Perhaps that's where your kidney
damage statements come from.
Always buy Mitragyna from a reputable and GMP certified vendor.
The American Kratom Association lists some vendors: https://www.americankratom.org/
I am so glad they are actively working on alleviating pain.
I know a guy who had horrid back pain. He was ok with opoids. He even admitted they reduced his pain, but he just felt better about life being on them.
His doctor just decided to not prescribe opoids for any reason.
My friend is miserable now, and takes too much Ibuprofen.
> His doctor just decided to not prescribe opoids for any reason.
From my unerstanding, you can only take them for about a week before they become addictive, and that in itself is fine, but they become less and less effective as time goes on as well. You've got to take more and more to get the same effect.
Opioids are really only good for short-term pain. Also, doctors are really under the gun right now because they have been overprescribing opioids for years and a non-trivial segment of the population (at least in the US) is addicted to them.
This is absolutely not true for everyone. I took oxycodone for three years without ever getting addicted, and it never stopped working. Thankfully, eventually enough surgeries and physical therapy finally worked to where I don't really need pharmaceutical pain management beyond normal OTC stuff, but for a while, there was no way I could have handled life without a whole lot of schedule II help, and I'm glad as hell this was before the addiction problem really took off in these economically depressed places among people who are jobless with terrible lives and no prospects and everyone blaming the drugs, so my doctors were never pressured into not prescribing them for people they clearly worked for.
It’s a shockingly common outcome though. Long term opioid use occurs in about 4% of people following their use for trauma or surgery related pain.. The odds get much worse when prescribed for long periods.
More research is being done nowadays on various terpenes for pain relief. Unfortunately, because it’s strongly associated the cannabis industry, it’s hard to get past all the noise to the good information like research papers.
Most of the terpenes in cannabis strains are also found in other plants to varying degrees. Pure extracts are available and legal without question.
I can’t say much about their efficacy though, because I haven’t done a deep dive. Id love to hear from anyone who has done the research or has personal experience, especially without THC or CBD along for the ride.
I had a similar thought, but in the other direction. I would be very curious to see how controlled doses of cannabinoids / cannabis oils compare to common opioid prescriptions for severe chronic and acute pain.
As far as terpenes specifically, I've been hearing some recent positive buzz about linalool.
As I understand it, paracetamol was discovered as the active metabolite of a much more damaging drug (acetanilide); and that most of paracetamol's effects is due to a metabolite of paracetamol in turn, namely AM404.
Why the pharmaceutical companies haven't done to paracetamol what they did to acetanilide, I don't understand. Providing AM404 directly would avoid the production of NAPQI in the body.
For me, I choose ibuprofen more often than paracetamol because 1) paracetamol carries a fairly serious overdose risk and is one of the common drugs people accidentally kill themselves with, and 2) paracetamol is not a true anti-inflammatory and doesn't help nearly as much with arthritis. Ibuprofen doesn't just relieve pain but actively reduces inflammation.
>The BMI decodes the onset of nociception via a state-space model on the basis of the analysis of online-sorted spikes recorded from the anterior cingulate cortex (which is critical for pain processing) and couples real-time pain detection with optogenetic activation of the prelimbic prefrontal cortex (which exerts top–down nociceptive regulation). In rats
>Example ChR2 expression in the prelimbic PFC. Highmagnification (100x) view of the expression of YFP-ChR2 in the prelimbic PFC demonstrated the co-staining of pyramidal neuron markers (CaMKII) with YFP. Arrows point to examples of co-stained neurons.
(from abstract and supplementary info, scihub is kind of down)
On their own (generally speaking!), very few neurons "respond" to low intensity light. "Optogenetics" stuff like this inserts a gene encoding a light sensitive ion channel in order to make cells responsive to a specific wavelength of light.
So there's two types of targeting here: Targeting gene expression to a certain population of cells, and then spatially targeting a group of those cells with the light - Blue light doesn't travel very far in tissue. (Also targeting multiple cell populations within a region using multiple colors of light + differently sensitive proteins).
Of course your comment still stands - Presumably not all the CamKII-positive PFC neurons are involved in nociception, and rats can't talk about their conscious experience so the answers there are limited to what questions researchers chose to ask using the limited tools available.
Expressing ChR2 at levels of CamKII is flipping crazy (but widely accepted by the research community). It makes up 6% of the proteins in the brain. Lol, I lol at optogenetic expression at that level as something that won’t have unintended consequences.
Yes, but there are surprising cases where broad stimulation is effective, like deep brain stimulation for Parkinson’s disease or cochlear implants. It’s surprising that you don’t need perfectly targeted stimulation patterns to achieve a therapeutic output, but often times it does seem to have a benefit.
We think you can do much better for many applications with targeted stimulation, and that’s the direction that many of these implant technologies are heading. I’m a Neuroscientist working on BCI
That's how most drugs primarily affecting the brain work. Not saying it's a good thing, but in the absence of better options, anything is better than nothing.
> Isn't that potentially stimulating millions or even hundreds of millions of neurons? We don't know what each individual neuron is doing. How is it possible to do this without causing bizarre malfunctions of the brain at best, or completely lobotomizing someone at worst?
Many psychiatric drugs affect large parts of the brain despite the drugs' efficacies being determined by their effects on much smaller parts of the brain.
For example, some anxiolytic and antidepressant effects are mediated by changes at certain serotonin-1A receptors in certain parts of the brain, yet common drugs like SSRIs change serotonin levels all over the brain and body.
You could categorize SSRI-induced activation of 5HT2C receptors as a 'bizarre malfunction', as it causes increased anxiety and dysphoria, which is the opposite of what you'd want if you're trying to treat anxiety or depression.
Alcohol works like this in the body, as well.
I'm skeptical of most brain implants for other reasons[1], though.
Pain is a vitally important function of the central nervous system. Children born without the ability to feel pain (congenital insensitivity to pain and anhydrosis/HSAN IV) rarely live to puberty.
There's very little to be gained from an implant that continuously supresses pain in an otherwise healthy person. It dramatically increases the risk of dying from preventable infections or permanently damaging tissue, bones and ligaments due to overburdening, untreated lesions or fractures.
It'd basically decrease combat readiness in the long run.
I wonder how healthy this actually is. Isn’t pain a signal the brain uses to alert you about a detected problem? Just eliminating the sensation of pain could mean your body would be unable to signal an issue that needs to be resolved.
> An inability to feel pain and temperature often leads to repeated severe injuries. Unintentional self-injury is common in people with CIPA, typically by biting the tongue, lips, or fingers, which may lead to spontaneous amputation of the affected area. In addition, people with CIPA heal slowly from skin and bone injuries. Repeated trauma can lead to chronic bone infections (osteomyelitis) or a condition called Charcot joints, in which the bones and tissue surrounding joints are destroyed.
You don’t have to completely eliminate it. Maybe someone suffering from cluster headaches only has to go through a migraine level of pain to realize there is a problem, not suffer through childbirth level pain every time an attack comes on.
Complete elimination of pain is probably not a good idea, for sure.
But the ability to actively shut off pain once you've acknowledged the problem, or at least numb it down to it not being completely debilitating, could be useful.
I recently had a very large kidney stone and let me tell you... It was bad enough to make me vomit. In cases like this it would be great to be able to self-medicate the pain.
However, I can also see how it could be abused to say "ah, it's not that bad" and not have the problem resolved. In my case, it could lead to permanent kidney damage.
I had a 5mm stone in late 2018. Even if a therapy based on this research had existed at that time, I doubt anyone would have suggested brain surgery when I presented with an acute abdomen at the ER. Granted I did end up having to have surgery for another stone the following year, but that surgery definitely did not have anything to do with my brain beyond anesthesia. That's not really the end of a human in which urologists specialize, you know?
It'd be one thing if I had a pre-existing chronic pain condition for which I'd already had such an implant installed, but even in that case I'd have to have enough access to ongoing care to have someone I could call and say "this hurts in a way that's new." The implant itself would need the same kind of management as does a pacemaker or ICD, I imagine. So it seems not tremendously likely that the scenario you describe would play out in practice.
(In any case, I'm good enough at withstanding pain that I waited two full days before deciding it was time to go to the ER, and even at that raised the mild suspicion of the doctor who attended me on the basis of how I wasn't screaming, vomiting, swearing, or otherwise showing much of anything beyond being pale and dehydrated. If it hadn't been for CT results unquestionably showing the calculus, I might've had some trouble with being misidentified as a drug seeker. So I'm not super sure the implant poses much more of a risk for inadvertent self-harm, you know? If I'd been in a worse way than I was, I could well have lost a kidney entirely through sheer stubbornness, no brain implant required.)
>But the ability to actively shut off pain once you've acknowledged the problem
That's not what this implant does though. It's all automatic within a few seconds which implies that you'd never be able to discern life threatening pain from stubbing your toe. It seems you'd receive an extremely short lived pain signal (if any) and then it'd be gone.
You'd have to give manual control to the individual for your suggestion to work and that comes with its own issues of "abuse"
>Once it detects an electrical signal that suggests “pain found,” it sends the information to the “sleeper agent,” a computer chip implanted in the front part of the brain. The chip then automatically triggers a light beam to stimulate the region, activating neurons that can override pain signals.
At first I thought the same as you, but for some chronic illnesses as rheumatoid arthritis where there is a lot of pain but no cure, the ability to turn pain on/off as needed (and under proper guidance) is probably something good.
Perhaps in someone with normal pain response, sure. But there are conditions which result in being in an almost constant state of pain. I could see this being a very useful tool in regaining some quality of life for people trying to manage these conditions.
> Isn’t pain a signal the brain uses to alert you about a detected problem?
It's a controversial topic, many believe that some of the pain your brain generates is for a problem it thinks you have, but don't. Usually this comes up in the context of back pain.
When you start reading up on certain types of chronic pain, there are quite a few "Doctors cannot find any physical problem causing the pain." Usually no treatment works for these people, as there is no problem to solve, except perhaps a brain anomaly.
Of course, disabling all pain would be a bad idea.
Yesterday I visited a friend with late stage cancer. He hasn't eaten or drunk anything for a few days. He doesn't really talk or move around anymore. I was just thinking a system like this would be perfect for him, if he could activate his morphine pump every time he feels pain. It's hard for his family to tell when they need to push the morphine button right now because he's non-verbal.
I don't know how well you know his family, but it would be good for them to get some advice from others that have been in that situation. I was in their shoes last year and it was incredibly stressful. I came out of it with a much clearer perspective.
Your assertion is equally as silly though. Pain is not necessary for life, but it definitely has a lot of merit as a survival mechanism and danger signal.
I think of pain as A signal, not the only one. So, to correct my assertion, i would say that we're not alive with the set of signals we have now. Then i would consider that alive means that we experience the same signals. BUT that means that a blind person is not alive. My initial statement is not accurate now.
Hell no! Pain is one of the biggest causes of human suffering. Having said that, until something better is "invented" pain is absolutely necessary, all those people who cannot feel or have a high tolerance to pain are always hurting themselves involuntarily. You lose your feedback signal.
I'm sure there's a middle ground between our default level of evolutionary baggage and no pain at all though. I wouldn't mind keeping burns and broken bones being painful, but I'd love to do away with minor annoyances like stinging nettles, wasps, and things like that.
Also being able to turn off pain to a specific problematic area would be nice too, I have a permanent headache from a neurological issue and it'd save me a lot on the quantities of CBD that goes into keeping that at bay!
I think the useful distinction is between acute pain, which is generally very useful, and chronic pain, which has huge negative effects with no known upside.
Agree. I recently read Pain is Really Strange (Steve Haines) and it was such a perspective shift on my understanding of how different the two are. (The illustrations are fantastic as well.)
Imagine if you could turn down pain like hitting the snooze button on an alarm. "Yes, I know my bone has been broken and I'm working on addressing it, please snooze all pain signals from that area for an hour."
If memory serves, this is also why leprosy sufferers often miss extremities. Their nerves are cut by the initial bacterial infection, and repeated (unnoticed) cuts so the rest.
> What’s especially neat is that the stimulated brain region normally doesn’t generate any sense of euphoria, the downfall of opioids. This means it’s likely to decrease the chance of addiction.
Ok, this is such a nonsense. Addiction is not caused by euphoria - it's caused because people can't stop taking it because of nasty withdrawals.
Now, when you are using it for chronic pain, you don't usually feel any euphoria, but pain relief.
I've been using prescribed opioids for years and I am really anxious about doctors falling for this kind of messaging. If I had my prescription stopped, that would be the end of life for me.
If this technique can relieve pain it can likely also cause it, and also cause pleasure. So it has the potential to become a technology for human puppetry. Or for self abuse, as in Larry Niven's wireheads. It isn't hard to imagine various modern regimes willing to implant control devices into prisoners, criminal or political.
There are a lot of regulatory concerns with these technologies due to this fear. Deep Brain Stimulation implants see the patient growing steadily accustomed to greater levels of stimulation - withdrawing the stimulation triggers deep existential depression.
This isn't as significant of a concern with a patient who has chronic untreatable major depression. But there is a legitimate fear that these implants could be used to disastrous effects on healthy individuals.
That's like, we can already print books, so digitizing them isn't anything new. Or, we can already walk from San Francisco to New York, a transcontinental railway isn't anything new.
Just by controlling pain you can control a person. If you implant a chip into a person that can remotely cause pain, you now have an electronic torture device, a torture device that does not leave marks.
It sounds very obvious, but there are some macroscopic medical phenomena that apply only to mice and small rodents. For example, I recently learnt that you can freeze hamsters and then "thaw" them in a microwave and they'll just wake and continue to live normally; this doesn't seem to work with humans unfortunately. Just imagine the applications, you wouldn't even need a regional hospitals; just freeze everyone and send them to a centralised mega hospital and ship them back when healed.
(As an aside, this was one of the first ever uses of a microwave.)
This reminds me of an episode of Black Mirror. The teenager has an implant that causes stressors to be blurred out, preventing anxiety.
<spoilers>
During a fight, she starts hitting her mom and, because of the involved stress, she's unable to see the physical damage she's causing, ultimately murdering her.
</spoilers>
If this was implemented broadly, it'd very quickly lead to reckless/dangerous behavior.
Though more broadly your point is likely correct that it will change some people's behaviour to do dangerous/stupid things because there's no negative feedback.
Please don't conflate pain relief with impossible-to-avoid-murdering-your-mother-when-you-feel-better syndrome. /s
Seriously, if I wasn't in as much pain as I am in then I would be out hugging people. Not hiding in my house, sitting on my hands to numb them and so I avoid touching a mouse for fear of searing pain for several days.
I promise I won't lead a (further) reckless life just because my idiopathic pain of 20 years is gone.
How is it perceived? As a cessation of pain? Or like early users of morphine described, "There's a pain in the room somewhere but I'm not sure it's mine."
The Hedonistic Imperative outlines how genetic engineering and nanotechnology will abolish suffering in all sentient life.
The abolitionist project is hugely ambitious but technically feasible. It is also instrumentally rational and morally urgent. The metabolic pathways of pain and malaise evolved because they served the fitness of our genes in the ancestral environment. They will be replaced by a different sort of neural architecture - a motivational system based on heritable gradients of bliss. States of sublime well-being are destined to become the genetically pre-programmed norm of mental health. It is predicted that the world's last unpleasant experience will be a precisely dateable event.
Two hundred years ago, powerful synthetic pain-killers and surgical anesthetics were unknown. The notion that physical pain could be banished from most people's lives would have seemed absurd. Today most of us in the technically advanced nations take its routine absence for granted. The prospect that what we describe as psychological pain, too, could ever be banished is equally counter-intuitive. The feasibility of its abolition turns its deliberate retention into an issue of social policy and ethical choice.
Let's think about the internet. Let's think about how it enables us to achieve instant communication all around the globe and freely share and distribute knowledge too great to hold in one's brain. I'd say the modern men are more than capable of overcoming biological barriers once thought to be fundamentally impossible to achieve.
It might be a fairly rough road to get there, but I'm certain our understanding of how our brains perceive pain and pleasure will be dramatically different in a 100 years, and it'll be for the better.
The internet is a great example of technology with negative implications that may never be understood. Television would be a good (but less potent) earlier example.
> Two hundred years ago, powerful synthetic pain-killers and surgical anesthetics were unknown.
But opium sure as hell wasn't! And it seems to check most of your suggested boxes too, however I don't think it makes for a good society, perhaps you should consider why, because it's pretty much what you're suggesting.
Why enjoy social interaction? Why enjoy arts? Why learn things? You'd be perfectly happy with more magic hedonism pills. Unpleasantness, and yes, pain is as important a part of being as any other part.
> Unpleasantness, and yes, pain is as important a part of being as any other part.
That's not really an argument; that's just "pain is an important part of being because pain has always been a part of our being". It's not hard to imagine a world where we can live without pain but still live meaningful lives.
The one thing I'd worry about is losing pain where it's useful. If I touch something hot, I want to know immediately (through pain) so I can quickly pull my hand away. But perhaps there's a different mechanism that could replace that.
To expand on said difficulty: the older I get, the more I believe Agent Smith was right when he said that "Humans define their reality through suffering and misery".
Also, homeostasis should dampen any long-term pleasure-inducing machinery (even if it comes from within).
> Unpleasantness, and yes, pain is as important a part of being as any other part.
While I agree in principle, reality is a lot more nuanced. For example, there is a very real difference between spraining your ankle (pain is a signal to rest it), and chronic nerve pain (which only serves to make the sufferer miserable).
I don't think we have to worry too much about ALL of sentient life, since all that's gonna be left of it soon is humans and pets and cattle.
> most of us in the technically advanced nations take its routine absence for granted
The absence of pain is not the absence of issues. Unless you can "solve" all (physical, psychological, societal) issues (and what would "solving" most of them even mean?), you're advocating for literally the cliche "treating the symptom and not the cause", Brave-New-World-soma-style.
How is it meaningful to say that a goal or project is instrumentally rational? It may be instrumentally rational to pursue a goal or project without regard to the means and only focusing on the ends...In other words the people executing it are instrumentally rational. But surely the thing itself cannot be said to "instrumentally rational" - what would that even mean? The goal is the goal. That is a value judgement that can be pursued in an instrumentally rational manner, but cannot itself be anything other than a goal valued by someone.
> The notion that physical pain could be banished from most people's lives would have seemed absurd. Today most of us in the technically advanced nations take its routine absence for granted.
LOL, that's absurd. I'm working from bed (again) because of constant back pain that spikes to unbearable if I stay upright for too long.
My favorite line from the show (which diverges significantly from the book, but I thought both were good in their own way) was when Bernard is stuck in the savage lands without his Soma, and cries "Is this what you people feel like all the time?!"
Is there a section that discusses “pain as a warning system?” This sounds great for chronic pain, but I have a hard time conceiving of how removing the immediate pain response to environmental stimulus works here.
Touch a hot stove => feel pain and recoil
People without a pain response have all sorts of problems with incidental injuries that rise in mortality since they are unaware of them. I’m guessing that the site has answers for that, because it’s such a basic objection, but it wasn’t apparent from reading the table of contents.
My dad cannot feel pain in his feet- it is terrible, as he often doesn't know they are even injured until he leaves bloody footprints around the house, or infection sets in deeply.
"Abolition" of all physical pain is an asinine desire that will only lead to our detriment.
They would deliberately set themselves up to need to run across hot sand to reach water? Why?
(I understand why a standard human might do that, but how would stranding oneself in a desert be adaptive? And if it isn’t adaptive, why would a hypothetical “harmonized human” do it?)
Out of all the things known to nature, humans find the most incredible ways to entertain and please themselves to death.
If you remove the element of pain and replace it with pleasure, people will find new and exciting ways to chase that pleasure too.
Run into unsafe neighborhoods at night and feel the joy of running back home. Roll around in broken glass and let the euphoria of stitching yourself back together set in.
> And if it isn’t adaptive, why would a hypothetical “harmonized human” do it?)
They'll do whatever you want them to do, because they are neither real nor human.
Something similar happened to an old friend of mine - he didn't know he had diabetes, and due to the resulting nerve damage in his feet had no idea anything was wrong until after gangrene had set in. I haven't seen him in a while but I understand he came out of it pretty well, in that he "only" lost a few toes and managed to keep most of his foot.
I hope your dad is managing ok and avoids this sort of mishap.
As someone with very mild / low-intensity chronic pain, this is promising. My number one fear, limiting me, is that it will get worse, despite medical assurances that it's unlikely. Tech like this could remove that fear and let me live my life (though with my personality, I have no doubt I will find something else to fixate on). I'm working on it with current approaches, but CBT and ssri's only work so well on me. I won't touch opiates with a ten foot pole, though for now, I don't need them. If I ever did, I'm sure my tune would change really fast.
I have also been hopeful of CRISPR targeting of pain, mimicking those with a genetic congenital inability to feel pain. https://directorsblog.nih.gov/2021/04/01/could-crispr-gene-e...
I am watching the progress, but when you suffer from pain and the anxiety from it, nothing comes soon enough. I'm also just a layman - if anyone here knows more and can comment on it, that would be cool.
Last, be weary of snake oil when it comes to any medical condition. Many are unscrupulous.
Opioid receptor modulators are being researched as an avenue for treating pain[1]. They don't cause opioid tolerance or addiction, but do offer increased pain relief, and some are available today like CBD, THC and other cannabinoids.
They seem kind of promising for pain that's alleviated well with opioids versus non-opioids.
Deep Brain Stimulation (DBS) has some well-known benefits in short term, in diseases such as Parkinson's (ref https://www.nature.com/articles/s41582-019-0145-9). Although, long term effects tend to fade in a lot of cases, and some patients have permanent neurologic damage after the procedure. Although exciting, there are a couple of non-surgical treatments to pain that have to be tried before invasive approaches.
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[ 5.0 ms ] story [ 213 ms ] threadAddiction is a phenomenon that predominantly happens in the brain, due to it constantly adapting to find homeostasis. And being unable to perceive pain when you should be is not homeostasis.
https://youtu.be/ESo8MM01Qv8
Wouldn't be very different to opioids or painkillers; just different mechanisms if action for similar phenomenon
> What’s especially neat is that the stimulated brain region normally doesn’t generate any sense of euphoria, the downfall of opioids. This means it’s likely to decrease the chance of addiction. And because the system only stimulates the brain when it detects pain signals, it lowers the chance the brain adapts to the stimulation.
source: Am heavy opioid user
But the point is, whether you're addicted or not, you cannot stop taking the drug. If you stop alcohol or smoking you might experience light to severe withdrawal symptoms depending on your level of use, even hospitalization. With opioids you will experiences months of crippling pain and inability to eat normally with the only remedy being more opioids. And you might not even know it's the opioids doing it because the doctors give that garbage out like candy and don't warn you about these side effects.
It says: "The chip then automatically triggers a light beam to stimulate the region, activating neurons that can override pain signals."
Isn't that potentially stimulating millions or even hundreds of millions of neurons? We don't know what each individual neuron is doing. How is it possible to do this without causing bizarre malfunctions of the brain at best, or completely lobotomizing someone at worst?
> Life follows a simple set of heuristics with an extensive set of exceptions.
And that's OK: heuristics allow a person to intuit some high-level behavior without having to derive it from the lower-level rules (laws). It's readily admitted that the heuristic isn't 100% accurate, and when it's inaccurate you fall back to that explicit derivation process.
From the outsider view of biology, there appear to be many heuristics for which we don't know how to derive from the underlying laws. Chemistry, at various points in time, has had similar issues, but over time we've expanded the amount of things we can derive from underlying physics. Biology, I hope, will follow in time.
This requires genetically engineered mice, which is why they only have this working for mice?
These kinds of implants have serious risks including infections etc, but for people with long term chronic pain there are few options.
"I can't go to work and feed my family because everything hurts so bad" can become a common statement for these people. In addition, addiction to painkillers, spending a huge percentage of your income at compounding pharmacies, and turning to illegal and possibly dangerous drugs to save a buck or to fill the gap between your needs and the insurance companies' coverage are all issues that a non-chemical pain management system like this could solve.
I'm sure it's dangerous and weird to toy with your brain but for many people in America alone the risk would be more than worth the reward.
The DEA tried to ban it a few years ago but too many cancer patients testified before Congress how well it worked compared to the prescription opioids. The DEA was forced to bow out.
The cool thing about Mitragyna speciosa is that it's a tree, a pretty hardy one. In my experience, the older trees have more potent leaves, but ideally, one could plant this tree in their backyard and never have to worry about being dependent on outside help for their pain ever again. You just dry the leaves and make tea from them.
It also fucks your kidneys, in a pretty short time of chronic use.
Mitragyna is affordable, shelf safe, and sustainable. It's a silver bullet compared to the unsustainable lifestyle that chronic pain doctors are pumping out with their prescription pads. What other questions do you have?
I've been taking Mitragyna for years and have no kidney issues. My kidney function is checked regularly and my GFR and BUN ratios are fine.
Secondly, any drug, even antidepressants, have some form of dependency. The withdrawal from Mitragyna isn't bad. With a simple taper, one can easily get off of it. I've done so myself a couple times. Google oxycodone withdrawal, Xanax withdrawal, Lexapro withdrawal..ad infinitum. Most controlled prescription drugs have far worse withdrawals.
Here's one bit of truth I'll agree with: buying Mitragyna from gas stations or head shops is a terrible way to acquire it. And these sources may be impure or tainted and cause health issues. Perhaps that's where your kidney damage statements come from.
Always buy Mitragyna from a reputable and GMP certified vendor. The American Kratom Association lists some vendors: https://www.americankratom.org/
I know a guy who had horrid back pain. He was ok with opoids. He even admitted they reduced his pain, but he just felt better about life being on them.
His doctor just decided to not prescribe opoids for any reason.
My friend is miserable now, and takes too much Ibuprofen.
From my unerstanding, you can only take them for about a week before they become addictive, and that in itself is fine, but they become less and less effective as time goes on as well. You've got to take more and more to get the same effect.
Opioids are really only good for short-term pain. Also, doctors are really under the gun right now because they have been overprescribing opioids for years and a non-trivial segment of the population (at least in the US) is addicted to them.
Most of the terpenes in cannabis strains are also found in other plants to varying degrees. Pure extracts are available and legal without question.
I can’t say much about their efficacy though, because I haven’t done a deep dive. Id love to hear from anyone who has done the research or has personal experience, especially without THC or CBD along for the ride.
As far as terpenes specifically, I've been hearing some recent positive buzz about linalool.
Why the pharmaceutical companies haven't done to paracetamol what they did to acetanilide, I don't understand. Providing AM404 directly would avoid the production of NAPQI in the body.
>Example ChR2 expression in the prelimbic PFC. Highmagnification (100x) view of the expression of YFP-ChR2 in the prelimbic PFC demonstrated the co-staining of pyramidal neuron markers (CaMKII) with YFP. Arrows point to examples of co-stained neurons.
(from abstract and supplementary info, scihub is kind of down)
On their own (generally speaking!), very few neurons "respond" to low intensity light. "Optogenetics" stuff like this inserts a gene encoding a light sensitive ion channel in order to make cells responsive to a specific wavelength of light.
So there's two types of targeting here: Targeting gene expression to a certain population of cells, and then spatially targeting a group of those cells with the light - Blue light doesn't travel very far in tissue. (Also targeting multiple cell populations within a region using multiple colors of light + differently sensitive proteins).
Of course your comment still stands - Presumably not all the CamKII-positive PFC neurons are involved in nociception, and rats can't talk about their conscious experience so the answers there are limited to what questions researchers chose to ask using the limited tools available.
We think you can do much better for many applications with targeted stimulation, and that’s the direction that many of these implant technologies are heading. I’m a Neuroscientist working on BCI
Many psychiatric drugs affect large parts of the brain despite the drugs' efficacies being determined by their effects on much smaller parts of the brain.
For example, some anxiolytic and antidepressant effects are mediated by changes at certain serotonin-1A receptors in certain parts of the brain, yet common drugs like SSRIs change serotonin levels all over the brain and body.
You could categorize SSRI-induced activation of 5HT2C receptors as a 'bizarre malfunction', as it causes increased anxiety and dysphoria, which is the opposite of what you'd want if you're trying to treat anxiety or depression.
Alcohol works like this in the body, as well.
I'm skeptical of most brain implants for other reasons[1], though.
[1] https://news.ycombinator.com/item?id=27135696
There's very little to be gained from an implant that continuously supresses pain in an otherwise healthy person. It dramatically increases the risk of dying from preventable infections or permanently damaging tissue, bones and ligaments due to overburdening, untreated lesions or fractures.
It'd basically decrease combat readiness in the long run.
> An inability to feel pain and temperature often leads to repeated severe injuries. Unintentional self-injury is common in people with CIPA, typically by biting the tongue, lips, or fingers, which may lead to spontaneous amputation of the affected area. In addition, people with CIPA heal slowly from skin and bone injuries. Repeated trauma can lead to chronic bone infections (osteomyelitis) or a condition called Charcot joints, in which the bones and tissue surrounding joints are destroyed.
1: https://medlineplus.gov/genetics/condition/congenital-insens...
But the ability to actively shut off pain once you've acknowledged the problem, or at least numb it down to it not being completely debilitating, could be useful.
However, I can also see how it could be abused to say "ah, it's not that bad" and not have the problem resolved. In my case, it could lead to permanent kidney damage.
It'd be one thing if I had a pre-existing chronic pain condition for which I'd already had such an implant installed, but even in that case I'd have to have enough access to ongoing care to have someone I could call and say "this hurts in a way that's new." The implant itself would need the same kind of management as does a pacemaker or ICD, I imagine. So it seems not tremendously likely that the scenario you describe would play out in practice.
(In any case, I'm good enough at withstanding pain that I waited two full days before deciding it was time to go to the ER, and even at that raised the mild suspicion of the doctor who attended me on the basis of how I wasn't screaming, vomiting, swearing, or otherwise showing much of anything beyond being pale and dehydrated. If it hadn't been for CT results unquestionably showing the calculus, I might've had some trouble with being misidentified as a drug seeker. So I'm not super sure the implant poses much more of a risk for inadvertent self-harm, you know? If I'd been in a worse way than I was, I could well have lost a kidney entirely through sheer stubbornness, no brain implant required.)
That's not what this implant does though. It's all automatic within a few seconds which implies that you'd never be able to discern life threatening pain from stubbing your toe. It seems you'd receive an extremely short lived pain signal (if any) and then it'd be gone.
You'd have to give manual control to the individual for your suggestion to work and that comes with its own issues of "abuse"
>Once it detects an electrical signal that suggests “pain found,” it sends the information to the “sleeper agent,” a computer chip implanted in the front part of the brain. The chip then automatically triggers a light beam to stimulate the region, activating neurons that can override pain signals.
It's a controversial topic, many believe that some of the pain your brain generates is for a problem it thinks you have, but don't. Usually this comes up in the context of back pain.
When you start reading up on certain types of chronic pain, there are quite a few "Doctors cannot find any physical problem causing the pain." Usually no treatment works for these people, as there is no problem to solve, except perhaps a brain anomaly.
Of course, disabling all pain would be a bad idea.
Right, I'll be sure to check back in 10-15 years.
http://www.uphs.upenn.edu/cep/COVID/mRNA%20vaccine%20review%...
That's a silly assertion. Pain isn't a hallmark of life--physical, mental, or otherwise. There's no 'merit' to it.
There are plenty of organisms without pain receptors that are definitely alive.
Pain doesn't correlate with how alive we are or the worth of our lives. Chronic pain sufferers would certainly rather not have pain.
https://en.m.wikipedia.org/wiki/Four_Noble_Truths
Also being able to turn off pain to a specific problematic area would be nice too, I have a permanent headache from a neurological issue and it'd save me a lot on the quantities of CBD that goes into keeping that at bay!
https://uk.singingdragon.com/products/pain-is-really-strange
Ok, this is such a nonsense. Addiction is not caused by euphoria - it's caused because people can't stop taking it because of nasty withdrawals. Now, when you are using it for chronic pain, you don't usually feel any euphoria, but pain relief. I've been using prescribed opioids for years and I am really anxious about doctors falling for this kind of messaging. If I had my prescription stopped, that would be the end of life for me.
This isn't as significant of a concern with a patient who has chronic untreatable major depression. But there is a legitimate fear that these implants could be used to disastrous effects on healthy individuals.
https://twitter.com/justsaysinmice
(As an aside, this was one of the first ever uses of a microwave.)
<spoilers> During a fight, she starts hitting her mom and, because of the involved stress, she's unable to see the physical damage she's causing, ultimately murdering her. </spoilers>
If this was implemented broadly, it'd very quickly lead to reckless/dangerous behavior.
Though more broadly your point is likely correct that it will change some people's behaviour to do dangerous/stupid things because there's no negative feedback.
Seriously, if I wasn't in as much pain as I am in then I would be out hugging people. Not hiding in my house, sitting on my hands to numb them and so I avoid touching a mouse for fear of searing pain for several days.
I promise I won't lead a (further) reckless life just because my idiopathic pain of 20 years is gone.
The abolitionist project is hugely ambitious but technically feasible. It is also instrumentally rational and morally urgent. The metabolic pathways of pain and malaise evolved because they served the fitness of our genes in the ancestral environment. They will be replaced by a different sort of neural architecture - a motivational system based on heritable gradients of bliss. States of sublime well-being are destined to become the genetically pre-programmed norm of mental health. It is predicted that the world's last unpleasant experience will be a precisely dateable event.
Two hundred years ago, powerful synthetic pain-killers and surgical anesthetics were unknown. The notion that physical pain could be banished from most people's lives would have seemed absurd. Today most of us in the technically advanced nations take its routine absence for granted. The prospect that what we describe as psychological pain, too, could ever be banished is equally counter-intuitive. The feasibility of its abolition turns its deliberate retention into an issue of social policy and ethical choice.
https://www.hedweb.com/
It might be a fairly rough road to get there, but I'm certain our understanding of how our brains perceive pain and pleasure will be dramatically different in a 100 years, and it'll be for the better.
But opium sure as hell wasn't! And it seems to check most of your suggested boxes too, however I don't think it makes for a good society, perhaps you should consider why, because it's pretty much what you're suggesting.
Why enjoy social interaction? Why enjoy arts? Why learn things? You'd be perfectly happy with more magic hedonism pills. Unpleasantness, and yes, pain is as important a part of being as any other part.
That's not really an argument; that's just "pain is an important part of being because pain has always been a part of our being". It's not hard to imagine a world where we can live without pain but still live meaningful lives.
The one thing I'd worry about is losing pain where it's useful. If I touch something hot, I want to know immediately (through pain) so I can quickly pull my hand away. But perhaps there's a different mechanism that could replace that.
Actually it's pretty hard to imagine it.
Tons of people conditions without adversity dwindle and end up shooting heroin, killing themselves, or worse, living long lives as accountants.
Also, homeostasis should dampen any long-term pleasure-inducing machinery (even if it comes from within).
While I agree in principle, reality is a lot more nuanced. For example, there is a very real difference between spraining your ankle (pain is a signal to rest it), and chronic nerve pain (which only serves to make the sufferer miserable).
I don't think we have to worry too much about ALL of sentient life, since all that's gonna be left of it soon is humans and pets and cattle.
> most of us in the technically advanced nations take its routine absence for granted
The absence of pain is not the absence of issues. Unless you can "solve" all (physical, psychological, societal) issues (and what would "solving" most of them even mean?), you're advocating for literally the cliche "treating the symptom and not the cause", Brave-New-World-soma-style.
One step further. If the universe has a purpose and we somehow solve the universe (maximize entropy or whatever), wouldn't humans cease to exist?
The truth is that we are beings of constant motion. We can't sit still.
How is it meaningful to say that a goal or project is instrumentally rational? It may be instrumentally rational to pursue a goal or project without regard to the means and only focusing on the ends...In other words the people executing it are instrumentally rational. But surely the thing itself cannot be said to "instrumentally rational" - what would that even mean? The goal is the goal. That is a value judgement that can be pursued in an instrumentally rational manner, but cannot itself be anything other than a goal valued by someone.
LOL, that's absurd. I'm working from bed (again) because of constant back pain that spikes to unbearable if I stay upright for too long.
(On a side note this guy owns some really interesting web domains)
Touch a hot stove => feel pain and recoil
People without a pain response have all sorts of problems with incidental injuries that rise in mortality since they are unaware of them. I’m guessing that the site has answers for that, because it’s such a basic objection, but it wasn’t apparent from reading the table of contents.
"Abolition" of all physical pain is an asinine desire that will only lead to our detriment.
And so people would seek it out. We already seek out every other form of pleasure- both positive (intimacy) and maladaptive (drugs).
If anything, this sounds like attempting to over-fit for fitness.
(I understand why a standard human might do that, but how would stranding oneself in a desert be adaptive? And if it isn’t adaptive, why would a hypothetical “harmonized human” do it?)
Out of all the things known to nature, humans find the most incredible ways to entertain and please themselves to death.
If you remove the element of pain and replace it with pleasure, people will find new and exciting ways to chase that pleasure too.
Run into unsafe neighborhoods at night and feel the joy of running back home. Roll around in broken glass and let the euphoria of stitching yourself back together set in.
> And if it isn’t adaptive, why would a hypothetical “harmonized human” do it?)
They'll do whatever you want them to do, because they are neither real nor human.
I hope your dad is managing ok and avoids this sort of mishap.
"In 2016, an estimated 20.4% of U.S. adults had chronic pain and 8.0% of U.S. adults had high-impact chronic pain." https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
I guess this depends on how you define "most".
Aside from the suffering of a boring life without suffering, like a pampered baby in a glass bowl...
I have also been hopeful of CRISPR targeting of pain, mimicking those with a genetic congenital inability to feel pain. https://directorsblog.nih.gov/2021/04/01/could-crispr-gene-e... I am watching the progress, but when you suffer from pain and the anxiety from it, nothing comes soon enough. I'm also just a layman - if anyone here knows more and can comment on it, that would be cool.
Last, be weary of snake oil when it comes to any medical condition. Many are unscrupulous.
They seem kind of promising for pain that's alleviated well with opioids versus non-opioids.
[1] https://www.pnas.org/content/118/16/e2000017118