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Guanfacine + morphine is a combination therapy being investigated as an adjunct treatment for managing opioid-induced hyperalgesia (OIH) and opioid tolerance in patients with chronic neck or back pain. Guanfacine is an alpha-2 adrenergic receptor agonist traditionally approved for hypertension and ADHD. In this therapeutic context, it is used to modulate pain pathways that contribute to the paradoxical increase in pain sensitivity and the development of tolerance associated with chronic opioid use. Morphine serves as the primary analgesic, acting on mu-opioid receptors. The combination is being evaluated in Phase 4 clinical trials led by Massachusetts General Hospital to determine if guanfacine can prevent or reverse the neurobiological changes that lead to OIH and tolerance, thereby improving the efficacy of long-term opioid therapy.
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