What is it about?

The so called "opioid crisis" may have as one of the causes the opioid induced tolerance and hyperalgesia. This paper, with a systematic review, is analysing the possible causes of the two phenomena and proposing possible remedies. The combination of drugs may significantly reduce the necessity of opioids for the treatment of chronic and acute pain, hence it may reduce the consequent phenomena like tolerance and hyperalgesia.

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Why is it important?

The abuse of opioids in the treatment of non cancer chronic pain has become very frequent, especially in some countries at low control. This paper is proposing some explanation of connected causes/consequences and suggesting some remedies.


The interest and the knowledge on the use of opioids in chronic non cancer pain is luckily increasing. So should the knowledge of the clinical pharmacology. This paper will be helpful in preventing two of the pharmacological consequences of the use of opioids: tolerance and hyperalgesia. It is particularly interesting because those two phenomena may be responsible of the potential abuse of opioids.

Professor Giustino Varrassi
Paolo Procacci Foundation

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This page is a summary of: A Pharmacological Rationale to Reduce the Incidence of Opioid Induced Tolerance and Hyperalgesia: A Review, Pain and Therapy, March 2018, Springer Science + Business Media, DOI: 10.1007/s40122-018-0094-9.
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