Is hyperalgesia a real thing?
Hyperalgesia is a phenomenon in which patients treated with opioids for pain or drug abusers using opiates for euphoria paradoxically become more sensitive to certain nociceptive stimuli. It typically occurs at high doses, so it may be more common in drug abusers using excessive doses than in legitimate patients using minimum effective doses. This is thought to be due to changes in the neurobiological systems that occur over time with high dose opioids. Both animal and human models have shown improvements in pain with tapering of high dose opioids, indicative of a hyperalgesic effect. The presumed phenomenon of hyperalgesia has been questioned among scientists, and there is limited evidence to support hyperalgesia. Many have hypothesized that it exists; however, there is no clear high-quality evidence to support this hypothesis.