Transition from acute to chronic pain after surgery

The Lancet, Journal Year: 2019, Volume and Issue: 393(10180), P. 1537 - 1546

Published: April 1, 2019

Language: Английский

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Evaluating psychosocial contributions to chronic pain outcomes

Progress in Neuro-Psychopharmacology and Biological Psychiatry, Journal Year: 2018, Volume and Issue: 87, P. 168 - 182

Published: Jan. 31, 2018

Language: Английский

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When pain gets stuck: the evolution of pain chronification and treatment resistance

Pain, Journal Year: 2018, Volume and Issue: 159(12), P. 2421 - 2436

Published: Sept. 17, 2018

Abstract It is well-recognized that, despite similar pain characteristics, some people with chronic recover, whereas others do not. In this review, we discuss possible contributions and interactions of biological, social, psychological perturbations that underlie the evolution treatment-resistant pain. Behavior brain are intimately implicated in production maintenance perception. Our understandings potential mechanisms produce or exacerbate persistent remain relatively unclear. We provide an overview these how differences relative contribution dimensions such as stress, age, genetics, environment, immune responsivity may different risk profiles for disease development, severity, chronicity. propose concept “stickiness” a soubriquet capturing multiple influences on persistence behavior, their stubborn resistance to therapeutic intervention. then focus neurobiology reward aversion address alterations synaptic complexity, neural networks, systems (eg, opioidergic dopaminergic) contribute stickiness. Finally, integration neurobiological what known about environmental social demands behavior explore treatment approaches based nature individual's vulnerability protection from allostatic load.

Language: Английский

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Opioids for the Treatment of Chronic Pain: Mistakes Made, Lessons Learned, and Future Directions

Anesthesia & Analgesia, Journal Year: 2017, Volume and Issue: 125(5), P. 1769 - 1778

Published: Oct. 20, 2017

An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause the "epidemic" prescription opioid abuse in United States. Yet, an examination statistics that led US Centers for Disease Control and Prevention to declare had reached epidemic levels shows occurrences deaths are arising outside hospital or hospice setting, which strongly implicates outpatient use treat chronic pain. Such related occurring patients themselves also through diversion. Overprescribing outpatients afforded distressed vulnerable individuals access these highly addictive drugs. The focus this article is what we have learned since treatment was first popularized at end 20th century how new information can guide management future.

Language: Английский

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Reward deficiency and anti-reward in pain chronification

Neuroscience & Biobehavioral Reviews, Journal Year: 2016, Volume and Issue: 68, P. 282 - 297

Published: May 29, 2016

Converging lines of evidence suggest that the pathophysiology pain is mediated to a substantial degree via allostatic neuroadaptations in reward- and stress-related brain circuits. Thus, reward deficiency (RD) represents within-system neuroadaptation pain-induced protracted activation circuits leads depletion-like hypodopaminergia, clinically manifested anhedonia, diminished motivation for natural reinforcers. Anti-reward (AR) conversely pertains between-systems involving over-recruitment key limbic structures (e.g., central basolateral amygdala nuclei, bed nucleus stria terminalis, lateral tegmental noradrenergic nuclei stem, hippocampus habenula) responsible massive outpouring stressogenic neurochemicals norepinephrine, corticotropin releasing factor, vasopressin, hypocretin, substance P) giving rise such negative affective states as anxiety, fear depression. We propose here Combined Reward Model (CReAM), which biopsychosocial variables modulating reward, stress functions can interact 'downward spiral' fashion exacerbate intensity, chronicity comorbidities chronic syndromes (i.e., chronification).

Language: Английский

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The Mesolimbic Dopamine System in Chronic Pain and Associated Affective Comorbidities

Biological Psychiatry, Journal Year: 2019, Volume and Issue: 87(1), P. 64 - 73

Published: Dec. 2, 2019

Language: Английский

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A Reciprocal Model of Pain and Substance Use: Transdiagnostic Considerations, Clinical Implications, and Future Directions

Annual Review of Clinical Psychology, Journal Year: 2018, Volume and Issue: 15(1), P. 503 - 528

Published: Dec. 19, 2018

Pain and substance use are highly prevalent co-occurring conditions that continue to garner increasing clinical empirical interest. Although nicotine tobacco, alcohol, cannabis each confer acute analgesic effects, frequent or heavy may contribute the development progression of chronic pain, pain be heightened during abstinence. Additionally, can a potent motivator self-administration, it escalating poorer substance-related treatment outcomes. We integrated converging lines evidence propose reciprocal model in which hypothesized interact manner positive feedback loop, resulting exacerbation maintenance both over time. Theoretical mechanisms bidirectional pain-substance relations reviewed, including negative reinforcement, social cognitive processes, allostatic load overlapping neural circuitry. Finally, candidate transdiagnostic factors identified, we conclude with discussion implications future research directions.

Language: Английский

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Pain-Induced Negative Affect Is Mediated via Recruitment of The Nucleus Accumbens Kappa Opioid System

Neuron, Journal Year: 2019, Volume and Issue: 102(3), P. 564 - 573.e6

Published: March 13, 2019

Language: Английский

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Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care

JAMA Internal Medicine, Journal Year: 2022, Volume and Issue: 182(4), P. 407 - 407

Published: Feb. 28, 2022

Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy mindfulness-based interventions for is uncertain.

Language: Английский

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Cortico-limbic pain mechanisms

Neuroscience Letters, Journal Year: 2018, Volume and Issue: 702, P. 15 - 23

Published: Nov. 29, 2018

Language: Английский

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