Opioid-induced hyperalgesia

Bannister, Kirsty

doi:10.1097/spc.0000000000000137

Cited by 41 publications

(22 citation statements)

References 46 publications

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“…It is known that opioid use itself can cause adaptations in the central nervous system that lead to increased pain sensitivity, termed opioid-induced hyperalgesia (OIH), 3,6,10,21,32,41,65,68,84,91,92 clinically first described over a century ago. 2 Opioid-induced hyperalgesia is at times confused with tolerance, which may be distinct in both mechanism and treatment.…”

Section: Introductionmentioning

confidence: 99%

Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon

Rieb

Norman

Martin

et al. 2016

Pain

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Section: Introductionmentioning

confidence: 99%

Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon

Rieb

Norman

Martin

et al. 2016

Pain

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“…Cancer-induced bone pain involves a complex interaction of various molecular events, and combines inflammatory and neuropathic pain (3). Although opioids are presently commonly used for the treatment of cancer-induced bone pain, prolonged or high-dose opioid treatment often results in the development of tolerance and even hyperalgesia (4,5). Therefore, it is important to understand the underlying mechanisms of morphine tolerance in patients with cancer-induced pain.…”

Section: Introductionmentioning

confidence: 99%

Monocyte chemoattractant protein-1 contributes to morphine tolerance in rats with cancer-induced bone pain

Liu

Gao

Ren

et al. 2016

Experimental and Therapeutic Medicine

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Cancer-induced bone pain can severely compromise the life quality of patients, while tolerance limits the use of opioids in the treatment of cancer pain. Monocyte chemoattractant protein-1 (MCP-1) is known to contribute to neuropathic pain. However, the role of spinal MCP-1 in the development of morphine tolerance in patients with cancer-induced bone pain remains unclear. The aim of the present study was to investigate the role of spinal MCP-1 in morphine tolerance in bone cancer pain rats (MTBP rats). Bone cancer pain was induced by intramedullary injection of Walker 256 cells into the tibia of the rats, while morphine tolerance was induced by continuous intrathecal injection of morphine over a period of 9 days. In addition, anti-MCP-1 antibodies were intrathecally injected to rats in various groups in order to investigate the association of MCP-1 with mechanical and heat hyperalgesia using the paw withdrawal threshold (PWT) and thermal withdrawal latency (TWL) tests, respectively. Furthermore, MCP-1 and CCR2 expression levels were measured using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis, and CCR2 expression levels were measured using RT-qPCR. The results indicated that MCP-1 and CCR2 expression levels were significantly increased in the spinal cord of MTBP rats. Intrathecal administration of anti-MCP-1 neutralizing antibodies was observed to attenuate the mechanical and thermal allodynia in MTBP rats. Therefore, the upregulation of spinal MCP-1 and CCR2 expression levels may contribute to the development of mechanical allodynia in MTBP rats. In conclusion, MCP-1/CCR2 signaling may serve a crucial role in morphine tolerance development in rats suffering from cancer-induced bone pain.

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“…[8][9][10] One group at special risk for expanding opioid use are patients with painful functional gastrointestinal disorders (FGIDs), unexplained GI symptoms with a predominant pain component such as irritable bowel syndrome (IBS) and functional dyspepsia (FD). Chronic opioid use may be particularly detrimental for this population, as chronic opioid exposure may actually worsen abdominal pain due to opioid induction of hyperalgesia, 11 and aggravation of IBS symptoms via alterations in intestinal transit and development of narcotic bowel syndrome. [12][13][14] IBS patients using prescription opioids report more severe GI symptoms, as well as poorer IBS-related and general…”

Section: Introductionmentioning

confidence: 99%

Opioid medication use in patients with gastrointestinal diagnoses vs unexplained gastrointestinal symptoms in the US Veterans Health Administration

Sayuk

Kanuri

Gyawali

et al. 2018

Aliment Pharmacol Ther

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SummaryBackgroundWhile opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit.AimTo compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role.MethodsVeterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID. This cohort study examined VHA pharmacy data to compare groups receiving ≥ 1 opioid prescription during the year and number of prescriptions filled. Bivariate and multiple logistic regression analyses adjusted for potential confounding factors (demographics, medical diagnoses, social factors) and identified potential mediators (service use, psychiatric comorbidity) of opioid use in these groups.ResultsA greater proportion of veterans with FGID received an opioid prescription during fiscal year 2012 (36.0% of 272 431) compared to only 28.9% of 1 223 744 in the SGID group (Relative Risk [RR] = 1.25). In multivariate logistic regression, personality disorders and drug abuse (OR 1.23 for each group), recent homelessness (OR 1.22), psychotropic medication fills (OR 1.55) and emergency department encounters (OR 1.21) were independently associated with opioid prescription use.ConclusionsDespite the potential for adverse consequences, opioids more often are prescribed for veterans with chronic, unexplained GI symptoms compared to those with structural diagnoses. Psychiatric comorbidities and frequent healthcare encounters mediate some of the opioid use risk.

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Opioid-induced hyperalgesia

Abstract: Looking to the future, improved clinician-patient communication, advanced diagnostic techniques and a refinement of prescribed adjunct pharmacotherapies will offer the most successful multimodal pain management approach to the problem of OIH.

Cited by 41 publications

References 46 publications

Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon

Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon

Monocyte chemoattractant protein-1 contributes to morphine tolerance in rats with cancer-induced bone pain

Opioid medication use in patients with gastrointestinal diagnoses vs unexplained gastrointestinal symptoms in the US Veterans Health Administration

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