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Opioid Tolerance Caused by Habitual Use

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Dr. Michael Lowenstein, co-medical director of The Waismann Method, an advanced procedure for rapid opiate detoxification under deep sedation, is encouraging Americans to familiarize themselves with the dangers of opioid-induced tolerance and hyperalgesia. Both conditions result from long-term use of opioid-based prescription drugs including, OxyContin, Methadone, Suboxone, Vicodin and Hydrocodone, which causes patients to take an increasingly higher dose to achieve the same desired results. Opioid tolerance is classified by a loss of the pain-relieving (analgesic) effects of the drug, while hyperalgesia, which can also manifest as tolerance, occurs when the pain threshold is reduced due to repeated opioid use.
“For physicians treating patients with chronic pain, the development of opioid tolerance and hyperalgesia are two primary concerns,” said Dr. Lowenstein. “There are numerous risks associated with long-term opioid use. Tolerance and hyperalgesia are among the most problematic and dangerous, as patients perceive the continuous need for stronger doses of their medications to accomplish the same level of pain relief.”
Tolerance to opioids is believed to be caused by physical changes to the opioid receptors on cell surfaces. One explanation is that during prolonged use these receptors experience “desensitization,” which causes the user to feel more pain, triggering the need for an elevated narcotic dosage. Another source of opioid tolerance is caused by a phenomenon where the opioid receptors are internalized by the cell itself. This process, called endocytosis, results in fewer opioid binding sites on the cell surface that are openly available to provide pain relief.
Opioid tolerance is well-documented around the world. In a study by Bhamb et al. 2006, approximately 61 percent of all physicians noted a concern about tolerance developing in chronic pain management patients. The condition is so prevalent that the FDA also applies its strongest caution, known as a “Black Box” warning to certain opioids. “Black Box” warnings are only used for those prescription drugs that cause serious negative effects, which have been thoroughly documented and studied.
Opioid-induced hyperalgesia may also be marked by an increased sensitivity to pain, and by the worsening of pain regardless of increasing doses of opioids. Pain may also become more widespread and develop beyond the sites of pre-existing pain. Hyperalgesia can develop with any opioid dose, but it is often associated with high doses of morphine or hydromorphone administered via injection, infusion or implantation.
The Waismann Method is a pioneering medical opiate detoxification procedure that is safe, humane and effective and provides an alternative option for treatment of prescription painkiller dependency. Performed in a hospital intensive care unit, the Waismann Method utilizes careful administration of medications to reverse the physiological dependence on opiates while the symptoms of withdrawal are addressed. During the procedure patients experience minimal conscious withdrawal. Following treatment, patients are opiate-free and stay at the Domus Retreat where they are supervised by a team of professionals as part of the recovery and transition process.

About The Waismann Method

Performed in a hospital intensive care unit, the Waismann Method involves cleansing receptors in a patient’s brain of the narcotics while the patient is under deep sedation, reversing the chemical imbalance. During the procedure, the patient will experience minimal conscious withdrawal, and will be able to return home within days. Seventy-five percent of the prescription drug dependent patients who are treated with the Waismann Method remain drug free after one year.

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