Opioid Induced Hyperalgesia
Have you taken opiate painkillers only to find that your pain has gotten worse? Opioid Induced Hyperalgesia, or OIH, occurs when the use of opioids reduces the pain threshold and can manifest as opioid tolerance. Pain can in fact become worse despite an increase in dose or escalation of use. The physiology behind this condition is not clearly understood and many medical personnel were initially skeptical of its origin. This paradoxical phenomenon poses a challenge for doctors, pain management specialists, anesthesiologists and other medical professionals trying to treat patients. It’s often hard for people to wrap their heads around the idea that medication prescribed to relieve pain is having the opposite effect. It creates an issue for doctors who may not be sure whether an increase in pain is related to hyperalgesia or if the injury, disease or condition has worsened.
Chronic pain conditions are very common and provide quite a challenge for the medical community. Opioids such as hydrocodone, oxycodone and morphine are often the drugs of choice for doctors and specialists treating severe acute and chronic pain resulting from a number of conditions. The use of these narcotic pain relievers can produce hyperalgesia, or opioid-induced pain sensitivity. Use can also lead to opioid tolerance, where the body becomes accustomed to the drug and no longer responds to its intended effects. Traditionally, it had been thought that a decrease of analgesic effectiveness was caused by the development of a tolerance or the progression of a disease or condition. Doctors are now coming to understand that increased pain can be caused by this opioid-induced pain sensitivity. In the case of OIH, it might make sense to increase the dosage to combat the pain, but the opposite is thought to be true. Tapering the dose may actually work to reduce pain.
Treating Opioid-Induced Hyperalgesia
Pain from OIH can be debilitating. Increasing the dose of opioid medication can be dangerous, leading to overdose and death. Once OIH is diagnosed, treatment options can include a reduction in the dose of opiates, a rotating schedule for use or the introduction of adjunct medications. This does not always work. Opioid Induced Hyperalgesia can be eliminated with a rapid detox procedure performed while patients are lightly sedated. Heightened pain sensitivity during opioid therapy is a real condition that can be treated. The Waismann Method of rapid detox can effectively rid the body of opiates in a matter of hours. Patients with persisting pain due to various conditions can then explore non-narcotic pain therapies or alternative pain management practices.
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