Adaptations of the Brain in Chronic Pain With Opioid Exposure I

Exclusion Criteria

• •Low back pain associated with any systemic signs or symptoms, e.g., fever, chills;
• •Evidence of rheumatoid arthritis, ankylosing spondylitis, acute vertebral fractures,
• •fibromyalgia, history of tumor in the back;
• •Other comorbid chronic pain or neurological conditions;
• •Involvement in litigation regarding their back pain or having a disability claim or receiving workman's compensation or seeking either as a result of back pain;
• •Diagnosis of current major depression or psychiatric disorder requiring treatment, or such a diagnosis in the previous 6 months;
• •Beck Depression Inventory II score of \>28;
• •Use of therapeutic doses of antidepressant medications at unstable doses (i.e., tricyclic depressants,
• •SSRIs, SNRIs; low doses used for sleep may be allowed);
• •Significant other medical disease such as diabetes, congestive heart failure, coronary or peripheral vascular disease, chronic obstructive lung disease, or malignancy;
• •Uncontrolled hypertension;
• •Renal insufficiency;
• •Current use of recreational drugs or history of alcohol or drug abuse;
• •Any change in medication for back pain in the last 30 days;
• •High dose opioid prophylaxis, as defined as \> 50mg morphine equivalent/day;
• •Any medical condition that in the investigator's judgment may prevent the individual from completing the study or put the individual at undue risk;
• •In the judgment of the investigator, unable or unwilling to follow protocol and instructions;
• •Evidence of poor treatment compliance, in the judgment of the investigator;
• •Intra-axial implants (e.g. spinal cord stimulators or pumps);
• •Pregnancy, or inability to use an effective form of contraception in women of child-bearing age;
• •Diabetes (type 1 or type 2);
• •Lactose intolerance;
• •Allergic reaction to naproxen or any NSAID;
• •Any untoward reaction to l-dopa or carbidopa.