Chronic Neuropathic Pain

To the Editor: Contrary to the conclusion drawn by Foley in the accompanying editorial (March 27 issue), 1 we believe that the excellent study by Rowbotham et al. 2 actually proves that central neuropathic pain is clinically unresponsive to oral opioids, even at high doses. Only 30 percent of the patients who had central pain after stroke or a focal brain lesion were able to complete the study, reporting only a 20 percent reduction in pain from base line. Other controlled studies support this assumption. In two studies of patients with central pain, morphine (18 mg given intravenously) was found to be . . .