Mechanisms of Opioid-Induced Tolerance and Hyperalgesia

Future Directions and Summary

The molecular mechanisms underlying opioid tolerance and opioid-induced hyperalgesia are being investigated in research laboratories throughout the world. Based on the research accomplished to date, it appears that these two phenomena may be related but also have distinct features. Future scientific efforts will be directed at deepening our understanding of how adaptive responses by multiple neural systems work together to counteract the analgesic efficacy of commonly used opioids. Future pharmaceutical development will focus on blocking the facilitatory mechanisms that produce these adaptive changes in the endogenous nociceptive and antinociceptive systems in response to continual exposure to an opioid analgesic. Development of diagnostic tests for biomarkers or genotypes that will allow identification of the opioid best suited to an individual patient's profile seems attainable within the not-too-distant future.

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Pain Manag Nurs. 2007;8(3):113-121. © 2007 Elsevier Science, Inc.