Evidence map›Paper›PMID 29922741›Full record

ArticlePain reports2018

Linking opioid-induced hyperalgesia and withdrawal-associated injury site pain: a case report.

Launette Marie Rieb, Wendy V Norman, Ruth Elwood Martin, Jonathan Berkowitz, Evan Wood, Michael John Milloy, Ryan McNeil

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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  4. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  5. Opioid prescribing in Canada: a continued retreat from God's own medicine.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Launette Marie RiebDepartment of Family Practice, University of British Columbia, Vancouver, BC, Canada.
Wendy V NormanDepartment of Family Practice, University of British Columbia, Vancouver, BC, Canada.
Ruth Elwood MartinDepartment of Family Practice, University of British Columbia, Vancouver, BC, Canada.
Jonathan BerkowitzSauder School of Business, University of British Columbia, Vancouver, BC, Canada.
Evan WoodBC Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada.
Michael John MilloyBC Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada.
Ryan McNeilBC Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada.
University of British Columbia · CASt. Paul's Hospital · CA

Funding

An ethno-epidemiological study of the implementation and effectiveness of an innovative and comprehensive response to the opioid epidemicR01DA044181 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI Thomas Kerr, Ryan McNeil · 2017 to 2026
$4.0M
Mentoring the next generation of addiction clinician scientists while responding to the opioid epidemicR25DA037756 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI FAIRBAIRN, NADIA · 2014 to 2023
$3.6M
NIDA NIH HHS R01 DA044181NIDA NIH HHS R25 DA037756
6 · The paper itself

Abstract

INTRODUCTION AND

objectivesUnderstanding the details of one individual's experience with pain, opioid use and withdrawal may generate insights into possible relationships between opioid-induced hyperalgesia and withdrawal-associated injury site pain (WISP).

methodsThis case study was extracted from a mixed methods study that characterized WISP. In 2014, the individual was recruited from a primary care clinic that prescribes opioid agonist therapy. In an interview, she completed a 35-item survey and elaborated on her own experience. Follow-up contact was made in June of 2017.

resultsThis 34-year-old white woman had several twisting injuries of her right knee between ages 13 and 15. The pain resolved each time in a few days, and she was pain free for 15 years. Around age 30, she initiated illicit oxycodone recreationally (not for pain) and developed an opioid use disorder. On detoxification, she experienced severe knee pain for 6 weeks that resolved postdetoxification but returned after subsequent oxycodone use and withdrawal episodes along with generalized skin sensitivity. This experience of WISP became a barrier to opioid cessation. Although nonsteroidal anti-inflammatories and gabapentin relieved WISP and methadone therapy assisted her opioid use disorder, an eventual change to sublingual buprenorphine/naloxone provided superior control of both.

conclusionThis case report illustrates that both opioid use and withdrawal can reactivate injury site pain, which can increase with dose escalation and repeated withdrawal events. The timing, trajectory, and neuropathic features of WISP reported here are consistent with those previously reported for the development of opioid-induced hyperalgesia, possibly linking these phenomena.

Indexed as

Drug dependenceHyperalgesiaOpioidsPainWithdrawal syndrome

Identifiers

PMID29922741
PMCPMC5999415
OpenAlexW2796043396

What OpenQuestion holds

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LicenceCC BY-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.