Opioid Tolerance Major Concern for Doctors Treating Patients with Chronic Pain

Patients under chronic pain management care with their doctor should pay close attention to the FDA warning on the labels of their medications. When you see what is known as the “Black Box” warning on a medication, this indicates the prescription drug may have serious adverse effects. Opioid-induced tolerance is becoming increasingly commonplace and doctors are very concerned about patients increasing the dosage of their medications over time. Hyperalgesia and opioid-induced tolerance are both conditions that seem to result from the long-term use of such opiate-based prescription drugs as OxyContin, Vicodin, hydrocodone and Methadone. The “Black Box” warning on opiate-based drugs means the drug has been thoroughly studied and its effects documented, and approximately 61 percent of all physicians have made note of a concern about adverse affects such as tolerance or dependency risks.

There are many risks associated with chronic pain management and the use of pain killers such as oxycodone over a long-term period. Long-term use may lead to physical changes in opioid receptors on the surfaces of cells. These receptors may experience “desensitization,” which causes the patient to feel more pain and produces the need for an increased dosage of the narcotic to get the same level of relief they once experienced. Increased tolerance to opiate-based medications is one of the first indications of a developing addiction, and anyone experiencing this should speak with their health care professional.

Recent research is beginning to show that over-stimulation of NMDA (N-methyl-D-aspartate) receptors through the chronic use of opiate drugs leads to the development of increased sensitivity to pain (hyperalgesia) and reduced pain-relief from opiates, even when the dosage is increased. In some cases of hyperalgesia, the pain can spread beyond the original pain site. NMDA-receptor activation is also associated with a variety of conditions such as dementia and Alzheimer’s disease as well.

Michael Lowenstein, who developed The Waismann Method of opiate detoxification , which uses heavy sedation to help detoxify patients rapidly from their drug dependency, encourages anyone being prescribed pain killers to become familiar with the many dangers of chronic use. Opiate tolerance can develop quickly and these powerful drugs taken to manage pain should be monitored carefully by a physician who understands the need to balance pain relief against the risks of developing addiction or hyperalgesia.