Opioids and Hyperalgesia

I imagine some of you think I'm crazy over the top w/my cautions about hyperalgesia, but I just saw the following:

Opioid use associated with increased pain sensitivity

Methadone-maintained patients and pain patients treated with methadone and morphine experienced hyperalgesia when exposed to a cold pressor test, placing the nondominant forearm in freezing cold water, but not with electrical stimulation, according to an observational Australian study, involving 40 participants, published in The Journal of Pain . Subjects taking opioids were tested just before a scheduled dose. The investigators did not note allodynia after application of von Frey hairs. The authors concluded that methadone-associated hyperalgesia is not only a phenomenon found with a particular population but reinforces the concept that hyperalgesia, but not allodynia, is associated with the long-term administration of opioids. The authors believe this is the first study to compare pain sensitivity to certain stimuli in chronic pain patients treated with morphine or methadone with methadone-maintained patients or healthy opioid-naïve control subjects. http://www.jpain.org/article/S1526-5...801-8/abstract Opioid use associated with increased pain sensitivity

Hyperalgesia in Opioid-Managed Chronic Pain and Opioid-Dependent Patients
Justin L. Hay, Jason M. White, Felix Bochner, Andrew A. Somogyi, Tim J. Semple, Bruce Rounsefell
The Journal of Pain - March 2009 (Vol. 10, Issue 3, Pages 316-322, DOI: 10.1016/j.jpain.2008.10.003)