“…The direct, affective and cognitive/associative components of pain and analgesia are mediated throughout central nervous system (CNS) regions containing μ-opiate receptors including periaqueductal gray, amygdala, lateral habenula, dorsal raphe, anterior cingulate, and prefrontal cortex (PFC) (Pastoriza et al, 1996 ; Wagner et al, 2001 ; Craggs et al, 2007 ; Wager et al, 2007 ; Petrovic et al, 2010 ; Stockton and Devi, 2014 ; Zeidan et al, 2015 ). A clear consensus on specific canonical pathways altered by COA has not been reached, however complex intracellular neuroadaptations in direct response to opioid administration (Chu et al, 2008 ; Drdla et al, 2009 ; Ueda and Ueda, 2009 ; Abul-Husn et al, 2011 ; Ziolkowska et al, 2012 ; Williams et al, 2013 ) initiate complex synaptic reorganization characterized by altered neurotransmission (Abul-Husn et al, 2011 ) and synaptic architecture (Russo et al, 2010 ; Abul-Husn et al, 2011 ; Stockton and Devi, 2014 ) such as decreased spine density (Robinson et al, 2002 ), cytoskeletal structure (Hou et al, 2009 ; Li et al, 2009 ), cell size (Russo et al, 2007 ), and neurotransmitter relevant protein distribution (Xu et al, 2003 ; Mickiewicz and Napier, 2011 ). Neuroadaptations initiated by COA are additionally contingent upon context-dependent associative components (Tiffany et al, 1991 ; Cox and Tiffany, 1997 ; Mitchell et al, 2000 ; Miguez et al, 2014 ) that together underlie the behavioral effects of repeated opioid administration.…”