Opioid tolerance and hyperalgesia

Med Clin North Am. 2007 Mar;91(2):199-211. doi: 10.1016/j.mcna.2006.10.003.


Opioids have been successfully used for the management of acute and cancer-related pain. Concerns regarding side effects, tolerance, dependence, addiction, and hyperalgesia have limited the use of opioids for the management of chronic nonmalignant pain. This article will review updated information from both clinical and preclinical studies regarding opioid-induced hyperalgesia, tolerance, and dependence. The implications of these issues in clinical opioid therapy also will be discussed.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / pharmacology*
  • Chronic Disease
  • Drug Tolerance*
  • Humans
  • Hyperalgesia / chemically induced*
  • Nociceptors / drug effects
  • Risk Factors
  • Substance-Related Disorders*


  • Analgesics, Opioid