Opioids for Chronic Non-Cancer Pain
Highlights
- Other effects of long-term opioid therapy have been described in recent years. These include hypogonadism, osteoporosis, immune suppression, cognitive impairment, and opioid-induced hyperalgesia (OIH). (View Highlight)
- The exact mechanism and location of OIH is uncertain, but five mechanisms have been suggested: changes in the central glutaminergic system mediated by activation of N-methyl-d-aspartate (NMDA) receptors; increased spinal dynorphins; activation of descending pathways; genetic mechanisms; and decreased neurotransmitter reuptake and enhanced nociceptive responses (View Highlight)