After being on opiods for years I've been told that most people get "hyperalagesia". Is this a fact? The current drs. seem to be minimizing or even dismissing my pain from lupus. How can you tell what's what, or how much is one or the other if true? All I know is that my pain goes with the other lupus symptoms, fluctuating as it always has even before the meds. And if true, how do you minimize it? Does it mean the pain is not valid?
There are few types of hepralgesia but I assume you mean- Opioid-induced hyperalgesia. This condition may develop as a result of long-term opioid use in the treatment of chronic pain. Various studies of humans and animals have demonstrated that hyperalgesia can develop in response to both chronic and acute exposure to opioids.
Opioid-induced hyperalgesia (OIH) refers to a phenomenon whereby opioid administration results in a lowering of pain threshold, clinically manifests as apparent opioid tolerance, worsening pain despite accelerating opioid doses, and abnormal pain symptoms.
Pain is primeraly unpleasant sensory and emotional experience. No one should dismiss your pain. In your situation, it would be best to find a professional who specializes in treating pain. If you have pain, it is valid, the question is what is the best course of treatment for your praticular situation.
Opioid induced hyperalgesia is a rare phenomenon and most pain Drs, if they are honest, will say they havent seen it. This is just a new reason/excuse for pain Drs to lower analgesic doses and to get people off opioid drugs. There is a lot of controversy in regards to treating non cancer pain with long term opioids right now. Many Drs are becoming afraid of being sited by the DEA for overprescribing (at least in the US) Groups like PROP (Physicians for Responsible Opioid Prescribing) are to blame for this scare-this group is petitioning the FDA to limit the prescribing of opioids to no more than 90 days and prescribing no one with non cancer pain more then the equivalent of 100mg morphine per day-they also want to strike the wording "for moderate to severe pain" to "severe pain only" when prescribing opioids to non cancer pain patients.
This is BS that is NOT based in evidence based medicine! There are no studies to support any of this groups claims but it has worked as a scare tactic to many PM docs in this country. If you have been on opioids all this time, it stands to reason that you are going to become tolerant. Tolerance (needing more drug to produce the same amount of analgesia) is a known phenomenon. It doesnt mean you are addicted. Your only recourse is probably to find another pain management Dr. I had to change PM docs for the same reason.
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