The Neuroscience of Pain and Addiction

Abstract

This chapter addresses the neurological architecture of both pain and addiction. The components of the relationship between the two are manifold, and include substances ingested; neurotransmitters and their receptor sites; cells, tissues, and organs and their integrated function. The author focuses on the basic neuroscience. The opening discussion (“Progress in Understanding Pain and Addiction”) maps our present understanding of both the plasticity of brain circuits and the fixity of drug effects. There follows a review of the anatomical structure of the brain, integrated with the known addiction and pain sensation processing pathways; an anatomical figure of the brain is provided. These descriptions lead to a scenario-based discussion of the implications for treatment of both pain and addiction: a patient with high pain tolerance experiencing pain, a patient with low pain tolerance experiencing pain, and the consequences of administering opioids. It concludes with therapeutic recommendations for management.