Mechanisms of Pain and Opioid Pharmacology

• Published in: Psychiatric annals Vol. 45; no. 10; pp. 511 - 515
• Main Authors: Oberbarnscheidt, Thersilla, Miller, Norman S.
• Format: Journal Article
• Language: English
• Published: Thorofare SLACK INCORPORATED 01.10.2015
• Subjects: Narcotics; Pain management; Pharmacology; Side effects
• ISSN: 0048-5713; 1938-2456
• DOI: 10.3928/00485713-20151001-06

Opioid-induced hyperalgesia (OIH) is a very common consequence of pain management with opiods. Characteristics of OIH are worsening pain over time despite an increased dose of the opioid. It is often recognized neither by the physician nor the patient, and it results in increasing doses of opioid medications and continued unsatisfying pain levels experienced by the patient. The increased use of narcotics has a negative impact on patient outcome, as patients suffer from increased pain levels and often develop depression. Patients with OIH require frequent assessment for aberrant behaviors as an indicator of addictive use. Opioid-seeking behavior may complicate the clinical picture of failed opioid therapy. The treatment of OIH is to discontinue the opioid medication and to treat the patient’s withdrawal symptoms, if necessary, in an inpatient setting with medical monitoring. Opioid-induced hyperalgesia (OIH) is a very common consequence of pain management with opiods. Characteristics of OIH are worsening pain over time despite an increased dose of the opioid. It is often recognized neither by the physician nor the patient, and it results in increasing doses of opioid medications and continued unsatisfying pain levels experienced by the patient. The increased use of narcotics has a negative impact on patient outcome, as patients suffer from increased pain levels and often develop depression. Patients with OIH require frequent assessment for aberrant behaviors as an indicator of addictive use. Opioid-seeking behavior may complicate the clinical picture of failed opioid therapy. The treatment of OIH is to discontinue the opioid medication and to treat the patient’s withdrawal symptoms, if necessary, in an inpatient setting with medical monitoring. [[ Psychiatr Ann . 2015;45(10):511–515.]