Overlapping Mechanisms of Stress-Induced Relapse to Opioid Use Disorder and Chronic Pain: Clinical Implications

摘要: Over the past two decades, a steeply growing number of persons with chronic non-cancer pain have been using opioid analgesics chronically to treat it, accompanied by markedly increased prevalence individuals opioid-related misuse, use disorders, emergency department visits, hospitalizations, admissions drug treatment programs, and overdose deaths. This misuse epidemic calls for well-designed randomized-controlled clinical trials into more skillful appropriate management developing effective which lower abuse liability are protective against stress induced pain. However, incomplete knowledge regarding approaches various types has worsened an under-appreciation overlapping neurobiological mechanisms stress, stress-induced relapse use, in patients presenting care these conditions. insufficient base unfortunately encouraged common prescription conveniently-available pain-relieving drugs liability, as opposed treating underlying problems team-based multidisciplinary, patient-centered, collaborative-care addressing co-occurring risk disorder. paper reviews recent findings pain, then discusses context key outstanding evidence gaps clinical-treatment research directions may be pursued fill gaps. Such directions, if conducted through randomized controlled trials, substantively inform practice general medical settings on how effectively pain-related distress