Latest studies have revealed that pain negatively impacts on reward processing and motivation leading to negative affective states and stress. These states not only reduce quality of life of patients by increasing the appearance of psychiatric comorbidities, but also have an important impact on vulnerability to drug abuse, including alcohol. In fact, clinical, epidemiological but also preclinical studies have revealed that the presence of pain is closely related to alcohol use disorders (AUDs). All this evidence suggests that pain is a factor that increases the risk of suffering AUD, predicting heavy drinking behavior and relapse drinking in those patients with a previous history of AUD. The negative consequences of chronic pain and its impact on stress and AUD are likely mediated by alterations in the central nervous system, especially in the stress and reward systems. Therefore, pain and stress impact on dopaminergic mesolimbic pathway can lead to an increase in drug abuse liability. In this mini review we analyze the interaction between pain, stress, and alcohol addiction, and how dynamic changes in the kappa opioid system might play a crucial role in the development of compulsive alcohol drinking in chronic pain patients.

中文翻译：

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中皮质边缘通路内强啡肽系统的疼痛引起的改变：对酒精成瘾的影响

最新研究表明，疼痛对奖励处理和动机产生负面影响，导致消极的情感状态和压力。这些状态不仅通过增加精神疾病的出现来降低患者的生活质量，而且对包括酒精在内的药物滥用的脆弱性也有重要影响。事实上，临床、流行病学以及临床前研究表明，疼痛的存在与酒精使用障碍 (AUD) 密切相关。所有这些证据表明，疼痛是增加患 AUD 风险的一个因素，可以预测那些有 AUD 病史的患者的酗酒行为和复发性饮酒。慢性疼痛的负面后果及其对压力和 AUD 的影响可能是由中枢神经系统的改变介导的，特别是在压力和奖励系统中。因此，疼痛和压力对多巴胺能中脑边缘通路的影响会导致药物滥用倾向的增加。在这篇小型回顾中，我们分析了疼痛、压力和酒精成瘾之间的相互作用，以及 kappa 阿片系统的动态变化如何在慢性疼痛患者强迫性饮酒的发展中发挥关键作用。