Abstract: Compositions and methods are provided for the treatment of pain. Compositions and methods are further provided for inhibiting the development of tolerance to addictive therapeutic agents (especially narcotic analgesics) in patients treated with such agents; for minimizing adverse effects (e.g., dependence) resulting from treatment with such addictive agents; and for enhancing pain relief resulting from narcotic analgesic administration. The compositions generally comprise a nontoxic VR1 antagonist, optionally in combination with an addictive therapeutic agent. Patients may be treated with a VR1 antagonist before, during or after administration of the addictive therapeutic agent to prevent, decrease the severity of, delay or treat tolerance and/or other adverse effects of the addictive agent in the patient.