Does tolerance = opiate hyperalgesia?

[ans]

My sense is that opiod tolerance is an adaptive thing - source of course unknown. It's also my albatross as I get so used to Rx' after 1.3 months that it's absurd.

This is a complicated subject above my head re: biology.

Has anyone experienced hyperalgesia where everwhere hurts and it kinda resembles complex regional pain syndrome?

Thanks in advance. Much!

ans

[Maria]

allan,
I am tired and don't even know if this is the right area of science to check out tho give ir a whirl and see what you can find out. How about portal vein and hepatic function.. anything going on medically that would affect either of these (just throwing this out as I am unable to sleep and have to get ready for Super Shuttle in a few hours).

Maybe the PMs you've seen aren't giving the question you have really serious thought or need to consult themselves in order to be able to answer the questions you pose (or not want to make the effort because they feel you are a difficult patient for even asking such questions). This doesn't mean to stop looking for an answer and I know you won't however you may have to go to get down and dirty with some scientists that are more into the abtract than the practical to answer your questions and maybe not even practicing actual medicine (prescribing/giving injections). Just a late night thought here from a sleep deprived person. Good luck.. I'll try to have better suggestions after I get back to CA and have some zz's on board.

Whatever happened to Job (Laura) and husband that used to post here. I think they're both scientists if memory serves me correctly and it probably doesn't tho if so maybe you can can get better directed in the branch of science that might try to answer this question.

ans..editing to add that the PMs I've seen in the past had stated that when a person isn't getting adequate pain relief w/high doses of oral pain meds then the move to morphine pump or implant would be considered. Just wondering if anyone has mentioned that to you altho it seems you're still within normal parameters of prescribed oral dosing tho the increase has been significant in a short period of time (so probably not having the pump/implant mentioned yet). Just wondering...

[ans]

Hi sleep-deprived Maria!

Thanks. This is somewhere in the literature and boy I wish I had full Medline/Pub Med access.

I know of one patient who was on astronomical opioid doses and he has an intrathecal pump of morphine to xylene in it. The hope is that he'll taper down and then have a spinal implant.

Uh, what efficacy do these implants have I wonder..I know there's spinal and peripheral but dunno the difference.

Best..

[ans]

I will add that Cedars-Sinai Pain Center is scared to death of "opiate-induced hyperalgesia". One doctor's answer to my pain was Baclofen (never did anything in the "good" days) and I almost burst out laughing and ran far as I'd die of abject pain from them.