A Guide to Opioid Induced Hyperalgesia

If you or your loved ones are struggling with Opioid Induced Hyperalgesia, you should be aware of what it exactly is and how to support your loved ones through it. It is a condition that can significantly reduce the quality of life. Let’s investigate what it is.

What Is Opioid Induced Hyperalgesia?

Many individuals struggle to grasp the idea of the condition opioid-induced hyperalgesia. While opioid drugs are developed to decrease pain, some individuals who take opioids too often or for a long period of time can experience an increase in the intensity and frequency of pain.

Scholars have researched this health issue in order to comprehend it and support the people experiencing it.

Individuals who take prescription opioids and indicate that the pain isn’t adequately controlled, improving, or somehow is increasingly worsening may have hyperalgesia.

Can Opioids Cause Pain?

Opioids have a lot of negative side effects. Chronic pain could be made worse by opioids. It can, for example, make migraines worse and much more recurrent. They can also make your back pain prolonged rather than lessened.

Before you turn to opioids for managing chronic pain, consider some of the safer and more effective alternatives. Medications and non-drug interventions are among them. Consult your physician to determine which alternatives are best for you.

What are Common Types of Opioid Drugs?

Hydrocodone (Vicodin), Oxycodone (OxyContin), methadone, and morphine are the most common types of opioids. Fentanyl’s a pain medication made from synthetic opioids. It is recommended for managing severe pain and is stronger than some other opioids.

The Opioid Pain Paradox

According to a study, opioids are the most common treatment for pain and they’re also becoming more used by people experiencing chronic pain.

However, long-term use of opiates is linked to a number of issues, such as an increased risk of antinociceptive tolerance, which means that greater dosages of the medication are needed across time to get the same level of analgesia.

Nausea, constipation, vomiting, somnolence, dizziness, and reduced mental clarity are all major consequences of large doses of opioids.

Furthermore, prolonged opioids exposure has been proven to cause paradoxical pain across areas untouched by the former pain complaints, which might then lead to dose elevation or the ‘analgesic tolerance.’

What Are the Symptoms Of Hyperalgesia?

The most common symptom of opioid induced hyperalgesia is a heightened sensitivity to the pain you experience with no injuries or the worsening of another ailment. For example, the surgical incision becomes more agonizing over time despite the fact that the incision is not inflamed and the patient has not sustained any new injury.

There are three major signs of Opioid-Induced Hyperalgesia:

• You experience an increasing discomfort in response to the external stimuli
• A rise in the severity of pain you are experiencing over time
• The pain spreads to a different part of the body from where it started

Hyperalgesia vs Tolerance to Opioids

Even though the 2 processes are similar, hyperalgesia differs from developing a tolerance.

When a person experiences tolerance to medication, it usually implies that the body has grown acclimated to the medication’s availability at the present dosage, as well as the medicine isn’t any longer effective. Whenever a person develops a tolerance to medicine, raising the dose usually alleviates their discomfort.

Drug tolerance differs from hyperalgesia. Here taking more pain medicine does not diminish the level of pain an individual experiences. Taking pain meds can sometimes exacerbate an individual’s pain.

A person with hyperalgesia when exposed to pain, for example, after surgery, their reaction towards that pain is much higher than predicted.

Hyperalgesia and Opioid Withdrawal Symptoms

Even though the clinical efficacy of opioids for managing pain is impaired by side effects, stopping opioids can produce very painful withdrawal episodes in persistent users.

Therefore, in this regard, opioid withdrawal presents a substantial difficulty in patients whose pain has subsided and thus no longer requires opioid treatment, especially in those people who are on excessively high dosages and a dosage decrease is necessary.

Symptoms of withdrawal such as abdominal pain, anxiety, sleeplessness, muscle pain, and hyperhidrosis usually appear between 8 – 48 hours following the last dose of opioids, based on the half-life of the drug.

To prevent these unpleasant physical, emotional, and autonomic symptoms, people feel obliged to keep using opioids. As a result, withdrawal is a major driver of prolonged opioid usage and a contributor to relapse.

The relapse or exacerbation of an existing pain issue is a possible side effect of stopping the opioid medication. Even though discomfort is a major concern, individuals on opioid medication report that withdrawal reduction is a much more essential factor in continuing to take opioids than managing the pain.

It’s tough to tell the difference between agony from an existing disease and discomfort from opiate withdrawal. Individuals may want increased opioid dosages to cope with an apparent increase in pain, although the underlying cause could be withdrawals instead of the aggravation of your existing pain problem.

Withdrawal is one of the primary reasons for continuing opiate use in non-prescription opioid consumers, and most of these people, like prescription opioid consumers, would be best positioned to quit if there were more successful treatment alternatives for reducing withdrawals.

How Is Opioid-Induced Hyperalgesia Treated?

Physicians may advise a patient suffering opioid-induced hyperalgesia to progressively decrease their opioid dosage, with the goal of eventually tapering off the medicine completely.

If the opioids aren’t working, and the pain is getting worse, or it’s becoming more generalized, you might want to look further into it. Here are some alternative treatment options.

Non-Medication Based Pain Management

The management of pain without the use of pharmaceuticals is known as non-pharmacological management of pain. There are focus and thought-altering techniques utilized to reduce and offer better control over the pain. These management techniques can include:

Psychoeducation And Conditioning

It’s distressing to not know how it works. Your level of stress will be a lot lower if you’re equipped and can predict what’ll happen.

Neurostimulation

It is also an effective technique. Following are examples of neurostimulation:

• Acupuncture
• TENS -Transcutaneous electrical nerve stimulation
• Acupressure

Alternative Therapies

Some alternative therapies can include hypnosis and behavioral therapy distraction techniques such as:

• Shifting your focus away from pain by guiding yourself through hypothetical mental imagery using the five senses.
• It’s beneficial to watch television or play music. Use diversion in moderation.
• Taking you through relaxing activities like breathing exercises and stretches can help you feel less stressed.

Medication-Assisted Treatment for Hyperalgesia

Elevated pain could be a withdrawal symptom that can last anywhere from days to weeks, therefore the taper must be done properly. Non-opioid drugs such as SSRIs, gabapentin, NSAIDs, gabapentin, and acetaminophen could be utilized to help reduce the pain.

A switch to an alternative opioid, like methadone, is often used to aid tapering and relieve opioid-induced hyperalgesia.

The Role of Fentanyl In Hyperalgesia

Fentanyl’s a pain medication made from synthetic opioids. It is recommended for managing severe pain and is stronger than some other opioids. According to a recent study, a greater dosage of fentanyl enhanced hyperalgesia in healthy subjects from 4.5 – 6.5 h while concurrently lowering pain scores

Risks Of Overdose with Opioid-Induced Hyperalgesia

Your body becomes accustomed to the effects of opioids when you are doing it for a long period of time. Over time, you may feel the need to take higher doses to achieve relief. As an outcome, you could develop an addiction to opioids. Overdosing is also a possibility. An overdose can be fatal. So, consult your doctor and avoid self-medicating.

If you feel like you have become dependent on opioids, seek help. It can be dangerous to take opioid medications too regularly and addiction can impact your daily life. Both of our Pathfinders Recovery Centers have a professional team that can guide you through supervised, medical withdrawal, provide guidance on alternatives to pain management, and lay the foundations for lasting recovery.