title: Opioid-induced hyperalgesia: clinically relevant or extraneous research phenomenon?
abstract: 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21231, USA. dtompki1@jhmi.edu
authors.forename: D Andrew
authors.initials: DA
authors.lastname: Tompkins
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Campbell
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D000818:Animals; D035843:Biomedical Research / Q000379:methods; D002908:Chronic Disease; D006801:Humans; D006930:Hyperalgesia / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods
chemical_list: D000701:Analgesics, Opioid