Rapid-Onset Opioid-Induced Neurotoxicity During Morphine Therapy

PurposeOpioid therapy is central to cancer pain management and aims to provide effective analgesia while minimizing neurotoxic adverse effects; however, cognitive dysfunction, delirium, and hallucinations continue to be significant complications.SummaryOpioid-induced neurotoxicity (OIN) has been associated with higher opioid doses, poor functional status, and advanced disease burden, and is frequently an underrecognized contributor to delirium. We describe an unusual case of visual and auditory hallucinations shortly after morphine exposure, with prompt reversibility after opioid rotation and recurrence upon rechallenge.ConclusionThis case strengthens the causal association between morphine exposure and hallucinations and emphasizes the importance of early recognition and opioid rotation in reversing opioid-related neurotoxicity.