CPCP: Opioid-Induced Hyperalgesia by Dr. Ashley Stillwell, DO

Dr. Ashley Stillwell, DO

Dr. Ashley Stillwell, DO

The last CPCP for the year 2014 is about a poorly understood phenomenon, Opioid-Induced Hyperalgesia (OIH). It’s an excellent review by one of our talented Family Medicine-Psychiatry residents, Dr. Ashley Stillwell, DO. It’s a very nice follow-up to a previous post on the topic.

While we probably ought to allow that OIH is a controversial syndrome, I’ve had to consider it many times over the years when I’ve been consulted in the general hospital to help patients suffering from pain which doesn’t seem to respond to standard (or heavy) doses of opioids.

In fact, you can search the American Pain Society website and find a number of documents on OIH. Often, I suggest a Pain Medicine consultation in difficult cases. Because we work in a “hyperspecialized and interdependent” environment, we can do that.

However, the chief difficulty, according to Dr. Stillwell’s presentation today, is that it’s tough to design studies that can distinguish between withdrawal, tolerance, and OIH.

balloonsSince this is the last CPCP of the year, we should celebrate.



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