Originally Posted by fmichael

Dear Kathy -

Pain can indeed do some pretty crazy things to us. And it can be induced in some pretty crazy fashions, "opioid-induced hyperalgesia" being one of them, where we can be on large enough doses of opioids that they not only become essentially useless but they ultimately reinforce and strengthen what is already CNS generated pain. For the quick treatment on Wikipedia, see, http://en.wikipedia.org/wiki/Opioid-...d_hyperalgesia

I just put up a long post on this in another thread, which path will you choose?
http://neurotalk.psychcentral.com/sh...d=1#post620879 (post no. 8.)

The post covers of few points, first, that at too high a level, opioids can actually cause more pain than they cure. Thus, before one ever assumes that the pain is as manageable is it’s going to get, you MUST have a conversation with a good pain dr. about the possibility of so-called opioid-induced hyperalgesia, it's causes and remedies: assuming of course you have been taking ant opioid at all.

The good news is that there are a number of fixes for the problem, including not only that old favorite, opioid rotation, but adding to the opioid another compound, whether it’s a so-called “NMDA receptor antagonist,” which could be as simple as the over-the-counter cough suppressant dextromethorphan in order to block pain processing from the spinal column to the brain, or the most minute amount (in millionths of a gram) of an opioid blocker which has the paradoxical effect of increasing the analgesic qualities of the narcotic while reducing the total amount taken, and therefore their side effects.

The bottom line is that no one should be resigning themselves to a life of absolutely intolerable pain, unless and until you’ve fully explored these issues and options with a good pain physician.

Mike