WHAT IS OPIOID INDUCED HYPERALGESIA? WHY IS IT IMPORTANT FOR PAIN PATIENTS?
When a patient uses morphine or any of its by-products, called, as a group, opioids, tolerance emerges over time. This is because of changes that happen at a cellular level and their opioid receptors, where the medication molecule connects to the cells. However, there might be something else happening as well. Opioid analgesics may cause more pain after a while instead of killing the pain. It means that the cells go through some changes, along with other changes in descending pain regulating pathways in spinal cord that results in less effect of opioids.
The importance of this phenomenon is for the pain patients who are using narcotic medications for a long time and do not get proper pain control. It would be better for these patients to be switched to another type of medication for a while. This is called opioid rotation. It means the patient will be taken off the primary medication and put on a lower dose of a different opioid. Nonetheless, at times it maybe needed to take the
patient off the opioids all together and after a while restart with a very low dose to achieve a better pain control.