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Medline ® Abstract for Reference 109

of 'Prevention and management of side effects in patients receiving opioids for chronic pain'

Opioid-induced abnormal pain sensitivity.
Mao J
Curr Pain Headache Rep. 2006;10(1):67.
Opioid analgesics are effective for treating many pain conditions. Opioid analgesic tolerance is a pharmacologic phenomenon that could affect the clinical use of opioid analgesics. Recent studies have shown that neural plasticity associated with the development of opioid tolerance may activate a pronociceptive mechanism that could counteract the analgesic effects of opioids. Thus, exposure to opioids could lead to two seemingly unrelated cellular processes (ie, the development of opioid tolerance and opioid-induced pain sensitivity). Their converging effects may be part of the mechanisms leading to the reduced opioid analgesic efficacy in chronic opioid therapy.
MGH Pain Center, Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, 02114, USA. jmao@partners.org