Opioid-Induced Hyperalgesia (OIH)

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By Brian Johnson, MD
Associate Professor Psychiatry and Anesthesia SUNY Upstate Medical University

Module Description: This online module explains the 21st Century concept of opioid induced hyperalgesia. Three percent of Americans are currently maintained on opioids for chronic pain. Some of these patients experience increasing pain and expect their opioid dose to go up. Participants will learn that the increased pain is often generated by nociceptive drivers being upregulated by opioid administration. Opioid pain pills cause pain. Mechanisms of pain exacerbation by opioids are explained. Management of these patients is discussed.

Learning Objectives:

  • Get the “big picture” about why opioid prescribing has accelerated recently, setting the environment for OIH to be commonplace
  • Know the definition of OIH
  • Know the neural mechanisms of OIH
  • Know the effect of methadone or buprenorphine maintenance on OIH
  • Know how long it takes to induce OIH

Note: This online module is not designated for AMA PRA Category 1 Credit™.