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Opioid-Induced Hyperalgesia: Clinically Relevant or Extraneous Research Phenomenon?

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Abstract

Opioids have become the unequivocal therapy of choice in treating many varieties of chronic pain. With the increased prescription of opioids, some unintended consequences have occurred. After prolonged opioid exposure, opioid-induced hyperalgesia (OIH), the paradoxical effect that opioid therapy may in fact enhance or aggravate preexisting pain, may occur. Over the past several decades, an increasing number of laboratory and clinical reports have suggested lowered pain thresholds and heightened atypical pain unrelated to the original perceived pain sensations as hallmarks of OIH. However, not all evidence supports the clinical importance of OIH, and some question whether the phenomenon exists at all. Here, we present a nonexhaustive, brief review of the recent literature. OIH will be reviewed in terms of preclinical and clinical evidence for and against its existence; recommendations for clinical evaluation and intervention also will be discussed.

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Disclosures

Dr. D. Andrew Tompkins has received a grant from the National Institute of Drug Abuse. Dr. Claudia Campbell has received travel expense compensation from Arcion Therapeutics, Inc.

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  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21231, USA

    D. Andrew Tompkins & Claudia M. Campbell

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  1. D. Andrew Tompkins
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  2. Claudia M. Campbell
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Correspondence to D. Andrew Tompkins.

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Tompkins, D.A., Campbell, C.M. Opioid-Induced Hyperalgesia: Clinically Relevant or Extraneous Research Phenomenon?. Curr Pain Headache Rep 15, 129–136 (2011). https://doi.org/10.1007/s11916-010-0171-1

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