This article from The Denver Post brings to light a phenomenon that is not well understood but many pain physicians see daily. Chronic pain patients seldom get amazing relief from opioids. A phenomenon, coined as Opioid Induced Hyperalgesia, occurs when use of opioids makes pain signals in the spinal cord more sensitive. In other words, by taking opioids the spinal cord can sometimes turn up the volume on the pain signals. The role of these messenger nerves in the spinal cord are usually to turn down the volume. Somehow, opioids can make them do the opposite.

There are many opioids out there. Other names for these drugs are opiates or narcotic pain killers. These drugs are all based on heroin. Commonly available opioids include morphine (Kadian, MS Contin), hydrocodone (Vicodin, Norco), oxycodone (Percocet, OxyContin), fentanyl (Duragesic), hydromorphone (Dilaudid) and many others.

This article talks about a study at the University of Colorado. Exposure of opioids after some pain in rats led to more chronic pain. These messenger cells in the spinal cord were more active in these rats. And the rats subsequently experienced more pain for a longer period of time. There have been numerous human studies that postulated this using alternative methods to study spinal cord and brain function.

Whether tolerance or Opioid Induced Hyperalgesia, chronic daily use of opioids for chronic pain have meager results at best. The risks of chronic opioid therapy often outweigh the potential for meager benefits. As we learn more about pain pathways in the spinal cord and brain, we will better understand how to harness the many options available to us now and develop new strategies moving forward.

Call Dr Sueno’s office today to discuss the limited role of opioids in any chronic pain syndrome.