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Long-Term Opiate Use Can Actually Make Chronic Pain Worse

Many people who suffer from chronic pain may not be aware that long-term opiate use can actually make chronic pain worse in some cases. The long-term use of opiates increases their sensitivity to pain stimulus, leading to the condition known as hyperalgesia.

The process of opioid-induced hyperalgesia (OIH) is according to the National Center for Biotechnology Information (NCBI) – “is generally thought to result from neuro-plastic changes in the peripheral and central nervous system (CNS) that lead to sensitization of pronociceptive pathways”.

In addition to the scientific explanation, the process of OIH occurs because the long-term use of opiate painkillers causes a decrease in your ability to tolerate pain, and an increased sensitivity to pain. When the pain increases, people are often led to believe they need to take higher doses of pain medication than they were on initially. This of course creates a vicious cycle of escalating the opiate doses as tolerance, dependence and potentially – addiction develops.

The prevalence of both OIH as well as the development of tolerance to opiates has made many MDs and physicians reconsider whether opiate as a pain therapy is the right choice for many different types of patients. Opioids are still considered to be useful for pain management in both palliative care as well as cancer patients however as a broad and generalized painkiller the medical community are not all on the same page as to their use and application.

Further complications also arise from long-term use and abuse of opiates. According to the Health-Hub Cleveland Clinic, Doctor Rosenquist states that – “After a while, patients are lucky to get 20 or 30 percent relief. Often, improvement in function and general well-being is even lower.” Not only can patients experience these large reductions in the effectiveness of the drug, but there are additional consequences from long-term use of opiates, including the following:

  • Weakened Immune System
  • Hormone Imbalances
  • Respiratory Depression
  • Sedation and Constipation

These symptoms from use and abuse of opiates are not all of the recorded or measured symptoms seen from those who are dependent or addicted to opiates. There are many other negative symptoms that decrease the quality of life for patients using opiates for whatever the reason. One should seriously consider their long-term use of opiates and whether other pain-management strategies can be employed to reduce pain. Of course, there are many cases where the controlled and responsible use of opiates is warranted, but there are also many alternative therapies that can dramatically improve someone’s pain and the ongoing management of their pain.


  1. http://www.spine-health.com/blog/how-pain-killers-sometimes-increase-chronic-pain
  2. http://health.clevelandclinic.org/2014/10/why-opioids-may-not-be-best-for-chronic-pain/
  3. http://www.ncbi.nlm.nih.gov/pubmed/21412369

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