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Opioid-induced Hyperalgesia: A Qualitative Systematic Review
Open accessAbstract
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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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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