Related Experiment Video
Updated: May 17, 2026
07:23
Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
Published on: July 29, 2014
[Pain in patients with opiates dependence]
Pascal Courty1, Nicolas Authier
1CHU G. Montpied, pôle de psychiatrie, SATIS, BP 69, 63003 Clermont Ferrand cedex 1, France.
Presse Medicale (Paris, France : 1983)
|October 23, 2012
Summary
Opioid-maintained patients often experience significant pain and require tailored analgesic strategies. Trusting patient reports is crucial for effective pain management in this population.
Area of Science:
- Pain Medicine
- Pharmacology
Context:
- Pain management is a critical aspect of patient care.
- Opioid therapy is frequently used for chronic pain.
- Opioid-maintained patients present unique challenges in pain management.
Purpose:
- To highlight the undertreatment of pain in opioid-maintained patients.
- To discuss the complexities of pain management in this population, including tolerance and hyperalgesia.
- To advocate for appropriate pain management strategies for opioid-maintained individuals.
Summary:
- Opioid-maintained patients report higher pain scores and experience both opioid tolerance and hyperalgesia.
- Despite these challenges, they remain responsive to opioid analgesia.
- Effective pain management necessitates understanding their need for baseline opioids, often termed 'opioid debt', requiring adjusted dosing regimens.
Impact:
- Emphasizes the need to trust patient self-reports of pain.
- Informs clinical practice regarding the undertreatment of pain in opioid-maintained individuals.
- Suggests that tailored, higher-dose, and more frequent opioid administration may be necessary for adequate analgesia.
Related Concept Videos
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
01:22Opioid Receptors: Overview
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2, D-Pen5]-enkephalin or DPDPE for...
01:17Drug Dependence
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
01:15Drug Abuse and Addiction: Pharmacological Phenomena
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...