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What Is Opiate Induced Hyperalgesia?

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opiate induced hyperalgesia
Most people think that taking opioid pain medication is supposed to take the pain away. In most cases, this is exactly what opioid drugs do. The issue becomes when the opioid doses are high and for an extended amount of time. Extended high doses of opiate drugs often lead to a condition called opioid-induced hyperalgesia. This condition essentially means that your pain continues to escalate, despite how much of a pain medication you take. In fact, it may be worse than the initial pain condition. Those who heavily use opioid pain medications should be aware of this issue. As the receptors on cells become bombarded with the opioid, it can lead to painful stimuli that become more painful with each dosage increase. Hyperalgesia contradicts the idea that taking more opioid medications makes the pain better; actually, it causes the opposite side effect.

Defining Opiate Induced Hyperalgesia

Those who have hyperalgesia tend to have a particular pattern in their medical history. First, they have an increasingly agonizing response to painful stimuli. For instance, touching a tender abdomen will actually be more painful despite the opioid medication on board. Second, the pain will start to diffuse to other areas of the body. As with abdominal pain, the pain may become less precise and travel to other parts of the body, such as the chest or even the arms and legs.
Usually, this reaction occurs at the higher doses of opioid use and abuse. It tends to occur when people take opioids through the bloodstream. For this reason, injecting high levels of an opiate can cause you to have more pain than you originally had. People who take large doses of prescription medication by mouth, such as Oxycodone and methadone, are susceptible to this condition.


Several biological factors in the body cause opiate-induced hyperalgesia. An example is the toxic effects of the by-products of opioids. The body uses or metabolizes the drug, and that metabolism produces waste. The waste products from this function can destroy nerves and tissue, causing more pain. Also, many other complex factors can contribute to this phenomenon. Certain receptors in the body, called NMDA receptors, can become stimulated by opioids, causing them to react with painful stimuli. Activation of spinal proteins called dynorphins can increase pain, and a protein called kinase C can cause more pain when opioid drugs activate it.

Hyperalgesia Treatment Options

The most effective way to treat this condition is to stop or reduce the current opioid you are taking. Of course, this isn’t easy via traditional methods. However, rapid detox via the Waismann Method can help you be opiate-free within hours. Opiate detoxification will often be enough to stop the hyperalgesia. Other medications that are less neurotoxic, such as methadone or morphine, are a less desirable choice in controlling this condition. You can also take a medication called ketamine to stop the activation of the NMDA receptors. However, this drug is habit-forming in its own right.
Next, you can try changing the route of administration. For example, switching from oral to intrathecal administration is not a common treatment for hyperalgesia. Finally, taking non-opioid pain medications, such as non-steroidal anti-inflammatory drugs, can help control the pain while tapering off the opioids. In the end, the best way to be free of this condition is by discontinuing opioid use altogether.
Although methadone is a treatment for hyperalgesia, it can still cause the condition or make it worse if you switch to it from another opiate. By undergoing rapid detox, you remove the problem medication from your body without experiencing the lasting withdrawal symptoms and can start alternative pain relief methods. For most people with hyperalgesia, this is usually the preferred choice.
Learn more about rapid detox.

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