Chronic pain alters drug self-administration: Implications for addiction and pain mechanisms.

Martin, Thomas J.; Ewan, Eric E.

doi:10.1037/a0013597

Cited by 45 publications

(29 citation statements)

References 89 publications

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“…The neuropeptide orexin (also known as hypocretin) has recently been implicated in both drug addiction (30) and CH susceptibility (31)(32)(33) and thus emerges as a potential candidate to explain the present findings.…”

Section: Discussionmentioning

confidence: 87%

Illicit drug use in cluster headache patients and in the general population: A comparative cross-sectional survey

Rossi¹,

Allena

Tassorelli

et al. 2012

Cephalalgia

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Section: Discussionmentioning

confidence: 87%

Illicit drug use in cluster headache patients and in the general population: A comparative cross-sectional survey

Rossi¹,

Allena

Tassorelli

et al. 2012

Cephalalgia

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“…For some patients, increasing pain might trigger craving for prescription opioids (Wasan et al, 2009); others might be using drugs to treat current pain or avoid future pain. Pain can be a strong motivator of behaviors that provide immediate relief or escape, and, accordingly, pain has been linked to greater self-administration of opioids in animal models (Martin and Ewan, 2008). Chronic pain also negatively affects inhibitory control (e.g., Apkarian et al, 2004; Verdejo-Garcia et al, 2009), thus depleting the cognitive and emotional control resources that are needed to resist urges to use opioids.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal association between pain severity and subsequent opioid use in prescription opioid dependent patients with chronic pain

Griffin

McDermott

McHugh

et al. 2016

Drug and Alcohol Dependence

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Background Patients with prescription opioid use disorder commonly report relief of chronic pain as the chief reason for first opioid use; indeed, the prevalence of chronic pain is high in this population. Understanding the association between pain severity and subsequent opioid use is crucial for understanding how to manage these conditions simultaneously and has not been examined in this population. The aim of this analysis was to examine the proximal effect of pain severity on opioid use during 12 weeks of buprenorphine-naloxone therapy for patients with chronic pain and prescription opioid use disorder. Methods This study is a secondary analysis of a national, randomized, controlled trial of buprenorphine-naloxone plus counseling for prescription opioid dependent patients. The association between past-week pain severity and opioid use in the subsequent week was examined in 148 patients presenting with chronic pain at baseline. Results Results from a multivariable logistic regression model showed that greater pain severity in a given week was significantly associated with increased odds of opioid use in the following week over the 12-week treatment, even after adjusting for covariates associated with opioid use (aOR=1.15, p<.001). Conclusions Despite previous reports of no association between baseline pain and subsequent opioid use, our findings suggest that patients who experience flare-ups of pain during treatment are prone to relapse to opioid use. Future studies may identify those who are at risk to use opioids by carefully monitoring patterns of their pain intensity over time.

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“…Appropriate doses of each opioid were based on previous studies in our laboratory and the literature (Martin and Ewan, 2008;Martin et al, 2007). The doses tested supported self-administration in ShA sessions.…”

Section: Escalation Of Opioids and Pr Schedulementioning

confidence: 99%

Compulsive-Like Responding for Opioid Analgesics in Rats with Extended Access

Wade

Vendruscolo

Schlosburg

et al. 2014

Neuropsychopharmacol

137

115

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The abuse of prescription opioids that are used for the treatment of chronic pain is a major public health concern, costing B$53.4 billion annually in lost wages, health-care costs, and criminal costs. Although opioids remain a first-line therapy for the treatment of severe chronic pain, practitioners remain cautious because of the potential for abuse and addiction. Opioids such as heroin are considered very rewarding and reinforcing, but direct and systematic comparisons of compulsive intake between commonly prescribed opioids and heroin in animal models have not yet been performed. In the present study, we evaluated the potential for compulsive-like drug seeking and taking, using intravenous self-administration of oxycodone, fentanyl, and buprenorphine in rats allowed long access sessions (12 h). We measured compulsive-like intake using an established escalation model and responding on a progressive ratio schedule of reinforcement. We compared the potential for compulsive-like self-administration of these prescription opioids and heroin, which has been previously established to induce increasing intake that models the transition to addiction in humans. We found that animals that self-administered oxycodone, fentanyl, or heroin, but not buprenorphine had similar profiles of escalation and increases in breakpoints. The use of extended access models of prescription opioid intake will help better understand the biological factors that underlie opioid dependence.

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Chronic pain alters drug self-administration: Implications for addiction and pain mechanisms.

Cited by 45 publications

References 89 publications

Illicit drug use in cluster headache patients and in the general population: A comparative cross-sectional survey

Illicit drug use in cluster headache patients and in the general population: A comparative cross-sectional survey

Longitudinal association between pain severity and subsequent opioid use in prescription opioid dependent patients with chronic pain

Compulsive-Like Responding for Opioid Analgesics in Rats with Extended Access

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