Hi Everyone, Forgive me if this is already well known on the forum. I have been doing a bit of research lately and came across some interesting information on how opiates make chronic pain worse and I thought I would pass it along in case anyone is in a similar situation. Basically, after a time, opiates screw up the way that our brain processes pain. The medical term for this is opoid induced hyperalgesia. Opiates activate cells in our brain and spinal cord called glial cells that have been found to be a key component in chronic pain. These glial cells cause neurogenic inflammation and greatly sensitize the nervous system to pain. Often, people will notice that not only are the opiates no longer helping their pain but they are making their pain worse. When the person attempts to increase their dosage to deal with the increasing pain their pain actually increases. The only way out of this cycle is to get off the opiates. I began researching this because I learned that a few Tmsers I knew were having their breakthrough either after they were completely off the opiates or as they were weaning off. I also noticed in myself that the meds seemed to be increasing my pain. Also, opiates make it so our brains do not produce the natural pain relieving endorphins. Obviously, after a time without the meds our brains heal. Exercise is said to be very helpful in the healing process. Here is a quick read on the phenomenon: http://www.medscape.com/viewarticle/811033 (Medscape: Medscape Access) How this all relates to the mechanism of TMS I am not entirely sure. There could certainly be a component of conditioned responses involved. For myself, it is pretty difficult to reach a point of outcome independence when I am watching the clock for my next dose of medication. This clock watching keeps me in the cycle of pain. Opiates also act as a safety net for me. Leaving the house for a long time without medication initially created a great deal of fear and anxiety. But just like everything else, as I reconditioned myself, it became much easier. I do not regret taking opiates. For a time they helped me to work, function as a father and allowed me to begin exercising again even if the pain relief was a conditioned response.