Primed for pain

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Science  04 Nov 2016:
Vol. 354, Issue 6312, pp. 569-571
DOI: 10.1126/science.354.6312.569

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It’s a perplexing and counterintuitive feature of opioid painkillers: At high doses, they actually seem to amplify pain by changing signaling in the central nervous system, making the body generally more sensitive to painful stimuli over time. The phenomenon, known as opioid-induced hyperalgesia, has been recognized in animals and in certain patients taking high doses of opioids. But how prevalent it is, and whether it plays a role in the U.S. epidemic of opioid abuse and overdose, is unclear. Although some discount the phenomenon as an oddity in the literature, a small group of researchers is struggling to understand its mechanisms and even counteract it with other drugs

  • * Photography by Matthew Rakola

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