Dual Diagnosis

Opioid-induced hyperalgesia (OIH) is a very common consequence of pain management with opioids. Characteristics of OIH

are worsening pain over time despite an increased dose of the opioid. It is oft en recognized neither by the physician nor the

patient, and it results in increasing doses of opioid medications and continued unsatisfying pain levels experienced by the patient. Th e

increased use of narcotics has a negative impact on patient outcome, as patients suff er from increased pain levels and oft en develop

depression. Patients with OIH require frequent assessment for aberrant behaviors as an indicator of addictive use. Opioid-seeking

behavior may complicate the clinical picture of failed opioid therapy. Th e treatment of OIH is to discontinue the opioid medication

and to treat the patient’s withdrawal symptoms, if necessary, in an inpatient setting with medical monitoring.