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Endogenous Opioids at the Intersection of Opioid Addiction, Pain, and Depression: The Search for a Precision Medicine Approach.
Annual Review of Neuroscience ( IF 12.1 ) Pub Date : 2020-07-08 , DOI: 10.1146/annurev-neuro-110719-095912
Michael A Emery 1 , Huda Akil 1, 2
Affiliation  

Opioid addiction and overdose are at record levels in the United States. This is driven, in part, by their widespread prescription for the treatment of pain, which also increased opportunity for diversion by sensation-seeking users. Despite considerable research on the neurobiology of addiction, treatment options for opioid abuse remain limited. Mood disorders, particularly depression, are often comorbid with both pain disorders and opioid abuse. The endogenous opioid system, a complex neuromodulatory system, sits at the neurobiological convergence point of these three comorbid disease states. We review evidence for dysregulation of the endogenous opioid system as a mechanism for the development of opioid addiction and/or mood disorder. Specifically, individual differences in opioid system function may underlie differences in vulnerability to opioid addiction and mood disorders. We also review novel research, which promises to provide more detailed understanding of individual differences in endogenous opioid neurobiology and its contribution to opioid addiction susceptibility.

中文翻译:



阿片类药物成瘾、疼痛和抑郁交汇处的内源性阿片类药物:寻找精准医学方法。



在美国,阿片类药物成瘾和过量服用的情况达到了创纪录的水平。这在一定程度上是由于它们广泛用于治疗疼痛的处方,这也增加了寻求感觉的用户转移注意力的机会。尽管对成瘾的神经生物学进行了大量研究,但阿片类药物滥用的治疗选择仍然有限。情绪障碍,特别是抑郁症,通常与疼痛障碍和阿片类药物滥用同时存在。内源性阿片类药物系统是一个复杂的神经调节系统,位于这三种共病疾病状态的神经生物学交汇点。我们回顾了内源性阿片系统失调作为阿片成瘾和/或情绪障碍发展机制的证据。具体而言,阿片类药物系统功能的个体差异可能是阿片类药物成瘾和情绪障碍脆弱性差异的基础。我们还回顾了新的研究,这些研究有望更详细地了解内源性阿片类药物神经生物学的个体差异及其对阿片类药物成瘾易感性的贡献。

更新日期:2020-07-09
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