Hyperalgesia: Opioids Actually Worsen Pain

opioid-induced hyperalgesia and chronic pain

Opioids are most often prescribed for the management of chronic pain. However, new research suggests that these medications may actually increase a person’s sensitivity to pain over time. This phenomenon, called hyperalgesia, provides further caution to healthcare providers about the long-term prescription of opioid pain medication.

Opioid-Induced Hyperalgesia

The word hyperalgesia literally translates to over (hyper) + pain (algesia), and it refers to an increased sensitivity to painful stimuli, which may be caused by damage to nociceptors or peripheral nerves. Hyperalgesia may take several forms, including occurrences in focal, discrete areas (primary), or diffused over all areas of the body (secondary). It can be caused through injury or, as recent research now shows, long-term use of opioid painkillers.
When a person experiences increased pain response due to opioids, their condition is referred to as opioid-induced hyperalgesia (OIH). Reports of this disorder have increased with the nationwide surge in opioid prescription over the past decade.
This condition may seem counterintuitive. How can medication meant to reduce pain actually result in worsened pain? While opioids work by blocking pain, the body reacts to their action by increasing the number of pain receptors. Acclimation to these medications also results in lower levels of endorphins, which serve as natural soothers for pain. When your endorphin levels dip, it is more difficult to deal with injuries and stimuli on your own.
Put simply, due to neural changes, something that wouldn’t normally result in pain will generate a pain response in a person with hyperalgesia, and painful occurrences will be stronger than normal.

Symptoms of Opioid-Induced Hyperalgesia

This condition has three main symptoms. The first, as stated above, is an increase in the intensity of pain felt over time. Second, people with hyperalgesia will experience spread of the pain to another location other than their point of injury. Finally, OIH results in an increase in the discomfort felt from external stimuli.
These symptoms present themselves even when a person increases their dosage of pain medication, with or without the advice of a physician. In fact, they will likely worsen with a heightened opioid dosage.
OIH is assessed through bedside tests, which include the pain intensity response to a cotton swab, finger pressure, pinprick, and cold or warm stimuli.

Other Side Effects of Opioids

Hyperalgesia is not the only health issue caused by long-term opioid use. These drugs have been the source of America’s opioid epidemic, a massive health crisis characterized by rapid dependence and addiction. Even with prescribed use, these drugs are incredibly habit-forming, meaning that people recovering from surgery or seeking help for chronic pain may find themselves reliant on opioids (and affected by OIH).
Signs of opioid addiction include…
  • Drowsiness or nodding off mid-conversation
  • Significant weight loss
  • Poor personal hygiene
  • Flu-like symptoms
  • Financial problems
  • Craving the drugs or increasing one’s dosage
  • Worsened work performance
  • Stealing money, items, or medication
  • Sleep problems
Addiction is a disease that affects the entire person, physically and mentally. People who develop a dependence on opioids may find themselves unable to function without them. They may exhibit drug-seeking behavior, cravings, and compulsive use. Over time, these behaviors may damage a person’s life, personally and professionally. It is vital for people with OIH to seek professional help as soon as possible.

Treatment for OIH

The best approach for the treatment of hyperalgesia is the tapering and even eventual discontinuation of opioid pain medications. This process may take a long time and will require the advisement of a physician and addiction specialist, who together will oversee the patient’s progress and response to the tapering. People who discontinue their opioid prescriptions may experience withdrawal, but with proper medical supervision, it is possible to limit one’s discomfort, symptoms, and existing pain while overcoming a dependence on these drugs.

Find Recovery from Opioids

Fortunately, evidence-based treatment is available. If you or a loved one have developed a dependence on opioids which has resulted in OIH, there is hope. At Hemet Valley Recovery Center and Sage Retreat, our team of clinicians can help you to overcome hyperalgesia and opioid dependence.
Our California Chronic Pain and Addiction Treatment Program is designed to help individuals who rely on narcotic analgesics to seek alternative pain management solutions. We provide medically managed detoxification and chemical dependency treatment supplemented by targeted therapeutic groups.
Through our biopsychospiritual model, patients learn alternative pain management strategies in group therapy, breathing techniques, music, poetry, yoga, acupuncture, exercise, physical therapy, massage, and other tailored programs.
To learn more about our services, contact us today.