Long-Term Opioid Use May Increase Sensitivity in Chronic Pain Management

Written By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II Date: April 20th, 2009. Topic: Member Blogs.

This month one of my News/Research Page postings addresses how long-term opiate use may be problematic for chronic pain management. I hear from treatment providers across the United States how many of the prescription opiate addicts they treat are amazed that once they are taken off of their medication they no longer have pain. Many of these patients have been taking chronic pain management medication for several years or more. I believe that what has occurred in these cases in an example of hyperalgesia.

Although you may already know what hyperalgesia is, I’m including a definition of opiate-induced hyperalgesia from Wikipedia for anyone unfamiliar with this phenomenon. This definition is also on my new research posting which you can read by Clicking Here and scrolling down to that posting.

Opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity is a phenomenon associated with the long term use of opioids such as morphine, hydrocodone, Oxycodone, and methadone. Over time, individuals taking opioids can develop an increasing sensitivity to noxious stimuli, even evolving a painful response to previously non-noxious stimuli (allodynia). Some studies on animals have also demonstrated this effect occurring after only a single high dose of opioids.

However, I always share with the treatment providers that there will also be many people who still have underlying chronic pain that needs appropriate medical intervention after the problematic medication is removed. One of the most successful detoxification and transitional chronic pain management medications for someone who became addicted to their pain medication is buprenorphine.

Subutex and Suboxone are the brand names that buprenorphine is being marketed for the treatment of opiate dependence. Both medications contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product. The second medication, Suboxone contains an additional ingredient called Naloxone to guard against misuse or abuse.

To learn about how to avoid problems with prescription medication used for chronic pain management and coexisting disorders including addiction please check out my article Avoiding the Prescription Drug Trap that you can download for free on our Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people udergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders including addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

If you would like training in this model we have two APM™ Certification Trainings scheduled this Spring—one in Sacramento California on May 18-19 and the one at Valley Forge Medical Center and Hospital on June 10-12. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call Ellen at (916) 575-9961 and ask her for the discount. For other upcoming trainings you can check out our Calendar page.

To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

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