Clinicians should look for specific symptoms to determine whether pain patients are developing opioid tolerance or suffering from opioid-induced hyperalgesia, pain specialist Dr. Sanford Silverman told the PAINWeek conference. Sensitization to pain medications can lead to "a diffuse, spreading kind of pain" with hyperalgesia, in contrast to a lack of efficacy related to drug tolerance, Silverman said. James Ray, clinical pharmacy coordinator for pain and palliative care at the University of Virginia Health Center, said hyperalgesia may not be as common as believed and that significant drug dosage increases that do not result in substantial improvement often are categorized as opioid-induced hyperalgesia.

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