ABSTRACT
As a clinical entity, opioid-induced hyperalgesia (OIH) presents as pain not
responding to, or worsening with, increasing doses of opioids. Hyperalgesia,
allodynia, and the development of new areas of pain further suggest this disorder.
The differential diagnosis and evaluation for this scenario have been discussed
previously. Once it seems likely that OIH is present, treatment is centered on
carefully decreasing the opioid dosing, also described previously. Other treat-
ment options include the utilization of adjuvant medications and opioid rotation,
which can be used preemptively or therapeutically (1,2).