Current Pain and Headache Reports

, Volume 15, Issue 2, pp 129–136 | Cite as

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

  • D. Andrew Tompkins
  • Claudia M. Campbell


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.


Opioid-induced hyperalgesia Pain hypersensitivity Opioid dependence Chronic pain Individual differences Quantitative sensory testing 



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.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA

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