What Did the Research Discover?
This study looked at whether people with a history of opioid use disorder (OUD) experience increased pain sensitivity and if this is linked to opioid use. Researchers analyzed 39 studies involving over 1,300 people with OUD and 700 people without OUD. The main focus was on how patients responded to cold pain, measured using a cold pressor test, which involves placing a hand in cold water to assess pain threshold and tolerance.
The results showed that patients undergoing opioid agonist treatment (such as methadone or buprenorphine) had lower pain thresholds and tolerated cold pain for a shorter time compared to those without OUD. On average, patients with OUD experienced pain 2 to 3 seconds earlier and tolerated it for 29 seconds less than those without OUD. This suggests that these patients are more sensitive to pain, a condition known as hyperalgesia.
However, the study could not determine whether opioid use itself caused this increased pain sensitivity. The results did not clearly link hyperalgesia to opioid tolerance, withdrawal, or abstinence. There were also concerns that some study results may have been exaggerated due to differences in sample matching and participant dropout.
How Can I Apply This Information?
If you have a history of opioid use disorder or are receiving opioid agonist treatment, you may experience increased sensitivity to pain, particularly cold pain. While it is unclear whether this sensitivity is caused by opioid use or other factors, it is an important issue that may affect your comfort and treatment experience.
Doctors and healthcare providers should be aware of this pain sensitivity when treating patients with OUD. Future research is needed to understand how hyperalgesia affects long-term well-being and treatment success. If you are experiencing increased pain, talk to your doctor about alternative pain management strategies that do not rely on opioids.
Source:
Trøstheim M, Eikemo M. Hyperalgesia in patients with a history of opioid use disorder: a systematic review and meta-analysis. JAMA psychiatry. 2024 Nov 1. https://pubmed.ncbi.nlm.nih.gov/39141367/
