Chronic Pain Management and Hyperalgesia

Written By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II Date: January 21st, 2010. Topic: Member Blogs.

Over the past twenty seven years I have worked with many people taking opiate medications who develop a condition known as opioid-induced hyperalgesia. Long-term use of opioids to manage chronic pain conditions increases patients’ sensitivity to certain types of pain, and similar hyperalgesia develops with methadone-maintained drug abusers as researchers from the University of Adelaide, in Australia, report. This observational study by Justin L. Hay, MD, and colleagues was posted is in the March 2009 issue of the Journal of Pain.

For those of you unfamiliar with this phenomenon here is the definition of opiate-induced hyperalgesia from Wikipedia.

Opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity is a phenomenon associated with the long term use of opioids such as morphine, hydrocodone, Oxycodone, and methadone. Over time, individuals taking opioids can develop an increasing sensitivity to noxious stimuli, even evolving a painful response to previously non-noxious stimuli (allodynia). Some studies on animals have also demonstrated this effect occurring after only a single high dose of opioids.If an individual is taking opioids for a chronic non-cancer pain condition, and cannot achieve effective pain relief despite increases in dose, they may be experiencing opioid-induced hyperalgesia. In this case, they may benefit from complete withdrawal from opioid therapy. Many individuals report reduced pain levels when opioids are withdrawn.

When people are undergoing chronic pain management they want help stopping or relieving their pain symptoms. What they may not realize is that some pain medications can actually cause or increase the pain that they are using the medication to manage. That is why it is crucial for people undergoing chronic pain management to educate themselves and learn as much as possible about their chronic pain condition as well as the most effective treatment options.

To learn more about effective chronic pain medication management please check out my article Managing Pain Medication in Recovery that you can download for free on our Article page. To learn about my upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

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