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Side-effects of opioids in chronic pain treatment

P G Lawlor1, E Bruera

  • 1Palliative Care Program, Grey Nuns Community Hospital & Health Centre, Edmonton, AB, Canada. plawlor@gpu.ualberta.ca

Current Opinion in Anaesthesiology
|October 3, 2006
PubMed

Insights

Opioid-induced neurotoxicity is increasingly recognized, with new insights into receptor and cellular mechanisms. Further studies are needed to clarify the clinical benefits of opioid rotation and dose reduction for managing opioid toxicity.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Toxicology

Background:

  • Opioid-induced neurotoxicity is a growing clinical concern.
  • Recent research has illuminated potential receptor and intracellular mechanisms.
  • Existing evidence suggests opioid rotation and dose reduction may alleviate toxicity.

Purpose of the Study:

  • To review the current understanding of opioid-induced neurotoxicity mechanisms.
  • To evaluate the clinical efficacy of opioid rotation and dose reduction in managing opioid toxicity.

Main Methods:

  • Literature review of recent studies on opioid-induced neurotoxicity.
  • Analysis of clinical data on opioid rotation and dose reduction strategies.

Main Results:

  • Emerging evidence points to specific receptor and intracellular pathways involved in neurotoxicity.
  • Clinical benefits of opioid rotation and dose reduction are reported but require further prospective validation.

Conclusions:

  • Opioid-induced neurotoxicity is a significant issue with identified underlying mechanisms.
  • Prospective studies are essential to confirm the relative value of opioid rotation and dose reduction in clinical practice.

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