Opioid-Induced Hyperalgesia Treatment

Modified on Jun 21, 2014 | Earth Clinic Team

Conventional treatment of opioid-induced hyperalgesia revolves around changing or eliminating the pain medication causing the severe pain. This is often followed with natural treatments such as exercise, ginseng and cayenne, which help restore the body’s ability to respond normally to pain once again.

What is Opioid-Induced Hyperalgesia?

Opioid-Induced Hyperalgesia is a long name for PAIN. In brief, pain medications (such as Oxycontin and hydrocodone) intended to relieve pain are now causing pain. This is a very frustrating condition for doctors, but particularly for patients. People who have been taking pain medications begin to experience unexplained and often severe pain that does not respond to treatment.

This is not a new problem. As long ago as the 1800s, doctors noticed that some patients who had become dependent on morphine were experiencing constantly increasing pain and referred to this condition as ‘morphia’. 

Exactly what is happening is still being studied, but what is known is that the brain has become confused by some chemicals in the opiates; the nervous system becomes affected. The person’s pain threshold becomes very low; a simple bump hurts horribly. People may increase the amount of pain meds they take to dangerous levels, but are only causing themselves more pain.

Treatment for Opioid-Induced Hyperalgesia

Currently, opioid-induced hyperalgesia treatment focuses on breaking the cycle of pain meds/pain/pain meds by changing or eliminating the cause: the pain medication. Which treatment is used depends on whether or not the illness that originally required pain medication has been cured.

Changing the Pain Medication

A different medication might help.  Methadone or buprenorphine are two such possibilities being used in treatment centers. If the reason for originally starting with the pain meds has been cured, then there will need to be gradual withdrawal or detoxification.

Ketamine Infusion

Ketamine was once used as an anesthetic during surgery. It blocks the NMDA and NMDAR receptors (involved with the central nervous system and the brain). As pain worsens, the number of NMDA receptors increases, transmitting more pain signals. Ketamine blocks those receptors and may stop the pain. However, Ketamine is dangerous and should only be tried when nothing else works. Research continues on other methods for blocking the NMDA and NMDAR receptors.

Drug Detoxification

Drug detoxification is done in a detox center or hospital to get all of the opiates out of the system.

Natural Remedies for Opioid-Induced Hyperalgesia

The body needs to regain its ability to produce endorphins, providing natural pain relief. Once the patient has gone through drug detoxification, these methods (and many others) will help re-train the body to generate natural endorphins. In addition to the alternative remedies below for opioid-induced hyperalgesia, aroma therapy with lavender and vanilla and eating some chocolate are reported to help increase endorphins.

Exercise

Any exercise will give you a rush of those feel-good endorphins. It doesn’t matter if you do it alone or with a group. It’s all good.

Cayenne

Cayenne has many health benefits (check it out in our Remedies section!). It provides detox support by stimulating the circulatory, lymphatic and digestive systems. Cayenne tea made with lemon and honey is an excellent total body detox.

Ginseng

For countless centuries, ginseng has been one of the most frequently used natural cures. Among its other benefits, ginseng is a great accompaniment to exercise because it delays fatigue, allowing muscles to be more efficient in their use of energy. It also balances the release of stress hormones.

Opioid-induced hyperalgesia is hyper-sensitivity to pain -- everything hurts. It is caused when the brain and nervous system scramble messages received from receptors. The body must first detox from the opiates. After that, natural remedies including exercise, cayenne and ginseng can help the body regain the ability to respond to pain normally.

Sources:

Opioid-induced hyperalgesia in humans: molecular mechanisms and clinical considerations.
Chu LF, Angst MS, Clark D. Clin J Pain. 2008 Jul-Aug; 24(6):479-96.

Opioid induced hyperalgesia: clinical implications for the pain practitioner.
Silverman SM. Pain Physician. 2009 May-Jun; 12(3):679-84.

Opioid hyperalgesia.
Bannister K, Dickenson AH. Curr Opin Support Palliat Care. 2010 Mar; 4(1):1-5.

Opioid-induced hyperalgesia: pathophysiology and clinical implications.
Mitra S. J Opioid Manag. 2008 May-Jun; 4(3):123-30.

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