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Opioid-induced Hyperalgesia: A Qualitative Systematic Review
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Opioids are the cornerstone therapy for the treatment of moderate to severe pain. Although common concerns regarding the use of opioids include the potential for detrimental side effects, physical dependence, and addiction, accumulating evidence suggests that opioids may yet cause another problem, often referred to as opioid-induced hyperalgesia. Somewhat paradoxically, opioid therapy aiming at alleviating pain may render patients more sensitive to pain and potentially may aggravate their preexisting pain. This review provides a comprehensive summary of basic and clinical research concerning opioid-induced hyperalgesia, suggests a framework for organizing pertinent information, delineates the status quo of our knowledge, identifies potential clinical implications, and discusses future research directions.
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“In humans and animal models, withdrawal from chronic opioid self-administration produces hyperalgesia (i.e., lower pain thresholds; Tilson et al., 1973;Angst and Clark, 2006).”
From Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development (2021) · cites this paper as Angst and Clark, 2006
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“This may be due to greater preoperative severity of pain, opioid-induced hyperalgesia and central or peripheral sensitisation to pre-existing nociception.23 69”
From Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis (2019) · cites this paper as [69]
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Bannister, K., & Dickenson, A. H. (2010) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0b013e328335ddfe · Cited by 64
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Nelson, A. M., Battersby, A. S., Baghdoyan, H. A., & Lydic, R. (2009) · Anesthesiology · doi:10.1097/aln.0b013e3181bdf894 · Cited by 62
Angst, M. S., Chu, L. F., Tingle, M. S., Shafer, S. L., Clark, J. D., & Drover, D. R. (2009) · Pain · doi:10.1016/j.pain.2008.11.001 · Cited by 63
Self-citationLong‐term opioid therapy in Denmark: A disappointing journey
Birke, H., Ekholm, O., Sjøgren, P., Kurita, G. P., & Højsted, J. (2017) · European Journal of Pain · doi:10.1002/ejp.1053 · Cited by 63
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Self-citationRemifentanil—Acute Opioid Tolerance and Opioid-Induced Hyperalgesia
Kim, S. H., Stoicea, N., Soghomonyan, S., & Bergese, S. D. (2015) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000019 · Cited by 62
Metadata
- Authors
- Angst, M. S., & Clark, J. D.
- Affiliations
- Stanford Medicine (US)
- VA Palo Alto Health Care System (US)
- ORCID
- Angst, Martin S.
- Venue
- Anesthesiology
- Published
- 2006-03-01
- Volume
- 104
- Issue
- 3
- Pages
- 570-587
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W2005703418
- Cited by
- 1,188
- References
- 176
- Citations by year
- 2026: 30 · 2025: 34 · 2024: 26 · 2023: 37 · 2022: 34 · 2021: 49 · 2020: 98 · 2019: 55 · 2018: 59 · 2017: 45 · 2016: 62 · 2015: 80 · 2014: 84 · 2013: 77 · 2012: 83
- FWCI
- 10.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- opioid-induced hyperalgesia, opioids, pain sensitivity, analgesic side effects, chronic pain, opioid analgesia
- MeSH terms
- Analgesics, Opioid, Animals, Humans, Hyperalgesia, Opioid-Related Disorders
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