HomeBlogServicesExploring Opioid-Induced Hyperalgesia: When the Cure Becomes the Cause

Exploring Opioid-Induced Hyperalgesia: When the Cure Becomes the Cause


This article will help you understand more about opioid-induced hyperalgesia, the symptoms, causes, and impact on your pain management strategy. It will help you better understand what opioid-induced hyperalgesia recovery looks like and your available treatment options. 


For a long time, opioids were considered an effective form of pain management strategy. This was particularly true for individuals with chronic pain. Opioids were considered a primary form of treatment, numbing patients to pain. Then, long-term symptoms like opioid-induced hyperalgesia and addiction began to manifest.

Today we understand that opioids should not be part of a long-term pain management strategy, particularly because of the high risk of addiction and opioid-induced hyperalgesia diagnosis. While the use of opioids for pain management can still provide effective relief for the first few weeks after surgery, if you are struggling with opioid-induced hyperalgesia, it’s important that you recognize the symptoms and find treatment so that you can enjoy recovery.

sad boy sitting floor

Mechanisms and Causes of Opioid-Induced Hyperalgesia

Opioid-induced hyperalgesia takes place when opioids enhance the pain that they are supposed to get rid of. 

To understand how it works, you need to better understand how pain works. Throughout the nervous system, you have nociceptors that detect pain when you bang your leg on a coffee table, get cut, touch a hot stove, or anything else. These send impulses up your neural pathways to the spine until they detect a specialized type of nerve cell called the interneuron.

Interneurons connect multiple nerves at the spine, and they function much like gates. They allow or block messages coming into the spine. At the base of the spine, decisions are made as to which messages collectively get sent to the brain. 

An opioid-induced hyperalgesia diagnosis happens when your nociceptors become sensitized. This means you experience severe pain because those nociceptors are being activated and sending messages through your neural pathways from multiple points throughout your body, even though there isn’t any actual source of pain. You might stop using opioids and, several months after the fact, still feel severe pain because of this sensitization. 


Getting an opioid-induced hyperalgesia diagnosis can be challenging for many people because symptoms may look similar to someone struggling with opioid addiction: no source of pain yet complaining about severe pain and in desperate need of additional medication.

Moreover, many people might let their prescriptions run out and still experience high levels of pain without opioids. This can lead to asking for more pain medication, which is also a sign of opioid addiction. 

Opioid-Induced Hyperalgesia Treatment and Management

Managing and treating opioid-induced hyperalgesia requires a multi-level approach.


First, it’s important to focus on prevention. There has been mounting evidence about the need for opioid-induced hyperalgesia recovery, but you will find yourself in a much better position if you are aware of the impact that opioids can have on your system and you incorporate other methods of pain management strategies into your recovery program.

This can help you if you just received an opioid prescription or if you have yet to receive one but might in the future.

Early Intervention

Early intervention is key if you have a prescription and are worried about opioid-induced hyperalgesia or opioid-induced hyperalgesia recovery. The sooner you can get help from your doctor, a psychotherapist, or a recovery center, the less severe your symptoms will be and the easier your recovery will be.


For those who are on opioids, tapering is important. Tapering is when you start to decrease the number of medications you take and slowly replace them with things like non-opioid alternatives or behavioral interventions.

Non-Opioid Alternatives

Non-opioid alternatives to pain management can serve as an essential replacement for any opioids and prevent the need for severe opioid-induced hyperalgesia treatment. This can include:

  1. Exercise
  2. Physical activity
  3. Physical therapy
  4. TENS units
  5. Over-the-counter and prescription acetaminophen, antidepressants, topical medications, anti-controlled NSAIDs, or steroids 
  6. Joint or trigger point injections
  7. Peripheral nerve blocks
  8. Behavioral therapy

Psychological and Behavioral Interventions to Address OIH

Chronic pain can often be treated with psychological and behavioral interventions such as cognitive behavioral therapy, which can reduce negative thinking associated with pain.

For example, when an individual experiences high pain driving to the store, their brain creates new information regarding driving and high pain. But this means that each subsequent time that same individual thinks about driving, gets in a car with someone else, is asked to participate in something that would require driving, has a new doctor’s appointment, or needs milk, that individual will start to perceive those experiences as high paying experiences. 

Perceptions influence reality, which means if an individual regularly associates certain activities with high pain, they will experience pain when driving.

With psychological and behavioral interventions as part of opioid-induced hyperalgesia treatment, individuals can learn to control that negative thinking, to put a stop to automatically assuming something will be painful, and, by extension, to directly influence the amount of pain they experience in real life.

disappointed alone adult man

Opioid Induced Hyperalgesia Recovery


The appropriate approach to opioid-induced hyperalgesia recovery is to slowly taper from high doses of opioids. This process takes a lot of time and patience and may not be the most comfortable, but it is the best for you. While you are tapering, it might be best to add non-opioid alternatives to help you manage the pain, such as behavioral interventions and other medication.


In other cases, you might get a recommendation to stop opioids together, which might warrant support from a drug and alcohol rehab center.

Several factors influence the duration and extent of your opioid-induced hyperalgesia recovery, such as how long you’ve been using opioids, if you’ve used other drugs in the past, your levels of pain, and more.

But during the recovery process, you can still receive support measures like behavioral interventions and physical therapy. 

Summing Up

Opioid-induced hyperalgesia can be a severe consequence of relying on opioids for pain management. It’s important for people to understand the risks of opioid dependence as well as the symptoms of opioid-induced hyperalgesia. 

You can minimize the risk of opioid-induced hyperalgesia by increasing awareness of it as a potential consequence of opioid use. You can also ensure that you receive personalized and comprehensive pain management approaches that rely on non-opioid alternatives.



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