American Board of Family Medicine (ABFM) Practice Exam 2026 - Free ABFM Practice Questions and Study Guide

The diagnosis of opioid-induced hyperalgesia applies to a terminally ill patient on a high dose of morphine who experiences diffuse pain upon touch. In this condition, patients who are on long-term or high-dose opioid therapy may paradoxically become more sensitive to pain rather than less. This phenomenon arises because opioids, while they effectively reduce pain in many cases, can also lead to an increased sensitivity to pain stimuli.

In such patients, the central nervous system may adapt to the presence of the opioid, leading to alterations in pain processing pathways. As a result, they may report heightened pain responses, even to stimuli that are normally non-painful, such as light touch or pressure. This is significant in distinguishing the problem as it helps direct treatment approaches, often suggesting a reduction in opioid dosage or a change in pain management strategies to better address the patient’s symptoms.

The other potential options, while relevant in different contexts, do not fit the specific scenario as accurately. For instance, peripheral neuropathy typically involves localized symptoms due to nerve damage, and somatic pain usually relates to musculoskeletal sources, neither of which aligns with the diffuse pain reported in this case. Medication withdrawal syndrome is characterized by specific symptoms upon reduction or cessation of opioid use,