A person who takes opioids for a long enough period will likely develop opioid induced tolerance. This is when the body adapts to the presence of the medication, resulting in a decrease in the drug's effectiveness over time. Opioids are drugs that are either derived from opiates, which are made from opium, or are related chemically to opiates. Opioids can include medications such as hydrocodone, oxycodone, buprenorphine and methadone.
Long-term opioid use can be dangerous because of issues such as dependence, addiction and overdose. Opioid induced tolerance can underlie all of these issues because as a tolerance develops, patients need increasingly higher doses of the drug to achieve analgesia. A person who is suffering from chronic pain just wants relief. They may not think about the effects of long-term opioid use and potential risks.
Opioid Tolerance Can Cause an Increase in Pain and May Be Linked to Hyperalgesia
The cause of opioid induced tolerance is complex but involves, among other things, the desensitization of opioid receptors. This can cause an increase in pain and the need for a higher dose of the medication. Another cause of opioid tolerance is when opioid receptors are internalized by the cell itself. This is called endocytosis and is marked by a decrease in opioid binding sites that are available to provide pain relief.
There is another condition that may overlap with opioid tolerance. This is opioid induced hyperalgesia. This occurs when prolonged use of opioids leads to a paradoxic increase in pain. This can occur despite increases in the opioid dosage. The pain can become more widespread, occurring in areas beyond where the original pain was located. Opioid induced hyperalgesia can occur with any dose of opioids but is often linked with high doses of morphine or hydromorphone.
Because of issues involving tolerance and hyperalgesia, chronic pain management can be tricky. Doctors should always try to weigh the benefits and risks, while assessing the disease or condition and its progression. There are plenty of non-narcotic options for pain relief, but many don't adequately treat persistent pain. This is why so many doctors prescribe opioids. Patients should be started on the lowest possible dosage of an opioid. Increases or a switch in medication can be made later if it's determined the current dosage isn't working.
Other Risks of Opioid Use Include Dependence, Addiction and Overdose
Opioids are unrivaled when it comes to pain management, but there are many risks that accompany them. These narcotic drugs can be habit forming and may lead to physical and/or psychological dependence. These medications are indicated for moderate to moderately severe pain and some are designed for pain that persists around the clock.
An increased sensitivity to pain can happen to anyone taking any dosage of an opioid. It's important that patients not increase their dosage without talking to a doctor. Opioids depress the central nervous system and high dosages can cause a potentially fatal overdose. Opioid dependence and addiction are very serious conditions that often necessitate professional treatment with detox, rehab or rapid opiate detox. This is a promising treatment that can eliminate the physical opioid dependency in a short amount of time.