The effective management of pain is a longstanding public health concern. Although opioids have been frontline analgesics for decades, they also have well-known undesirable effects that limit their clinical utility, such as abuse liability and respiratory depression. The failure to develop better analgesics has, in some ways, contributed to the escalating opioid epidemic that has claimed tens of thousands of lives and has cost hundreds of billions of dollars in health-care expenses. A paradigm shift is needed in the pharmacotherapy of pain management that will require extensive efforts throughout biomedical science. The purpose of the present review is to highlight the critical role of the behavioral scientist to devise improved translational models of pain for drug development. Despite high heterogeneity of painful conditions that involve cortical-dependent pain processing, current models often feature an overreliance on simple reflex-based measures and an emphasis on the absence, rather than presence, of behavior as evidence of analgesic efficacy. Novel approaches should focus on the restoration of operant and other CNS-mediated behavior under painful conditions.

中文翻译：

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开发改进的疼痛翻译模型：行为科学家的作用

有效治疗疼痛是长期以来对公共卫生的关注。尽管阿片类药物已成为一线止痛剂数十年，但它们也具有众所周知的不良作用，从而限制了其临床实用性，例如滥用倾向和呼吸抑制。无法开发出更好的止痛药，在某种程度上加剧了阿片类药物的流行，这种流行已经夺走了成千上万人的生命，并花费了数千亿美元的医疗费用。疼痛治疗的药物治疗需要发生范式转变，这将需要整个生物医学领域的广泛努力。本文的目的是强调行为科学家的关键作用为药物开发设计改良的疼痛翻译模型。尽管涉及与皮质相关的疼痛处理的疼痛状况存在高度异质性，但当前的模型通常以过度依赖简单的基于反射的测量为特征，并强调缺乏（而非存在）行为作为止痛药的证据。新颖的方法应着重于在痛苦的条件下恢复操作员和其他中枢神经系统介导的行为。