Neurobiological aspects of pain in the context of alcohol use disorder

Cucinello-Ragland, Jessica A.; Edwards, Scott

doi:10.1016/bs.irn.2020.09.001

Cited by 18 publications

(12 citation statements)

References 173 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consider for example that there is a significant comorbidity between mental health and chronic pain issues (Cucinello-Ragland & Edwards, 2021; Kleykamp et al, 2021; Kohrt et al, 2018), yet it is rare that participants afflicted with both are included in studies, therefore outcomes on a given treatment for either/both are challenging to differentiate (Kirsh, 2010; McParland et al, 2021; Myhr & Augestad, 2013; Weeks et al, 2016). Some authors argue a causative relationship, while others point to the overlap in symptomatology, functional issues, and treatments making diagnostic distinctions difficult (Aronoff, 2016; Fornasari, 2012; Kynast et al, 2013; Rieder et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study to Determine the Impact of Psychedelic Therapy for Dimensional Measures of Wellness: A Qualitative Analysis of Response Data

Virgilio

Minerbi

Fletcher

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: The World Health Organization (WHO) defines wellness as the optimal state of health of individuals and groups. No study to date has identified the impact of psychedelic medicines for optimizing wellness using a dimensional approach. Treatment effects can be measured more broadly using a composite score of participants global perceptions of change for pain, function, and mood scores. Given the precedence in previous work for retrospective study of participants self-medicating with these substances, the nature of this study design allows for a safe way to develop further evidence in this area of care, with wellness as the broad indication. Methods: 65 civilian or military veterans between the ages of 18-99 self-identifying as having used psychedelic medicines for non-recreational therapeutic purposes in the last 3 years were recruited for this study. Participants completed various standardized questionnaires that will be analyzed in a separate study, while this study analyzed the qualitative experiences described in relation to the medicines used and coded them according to themes developed from review of previous literature. Results: A total of 93 comments were analyzed. Participant comments were classified into these categories: mysticism and spirituality, functional improvement and self awareness, social connection and cultural impact, impact on medical and mental health conditions, neutral impressions, sensations or difficult experiences. Participants described impacts in these categories related to spiritual, physiological, psychological, and social improvements, as well as difficulties and complex emotions regarding the experience of using psychedelic medicines. Discussion: Wellness of individuals or groups is not simply an absence of disease, symptoms, or impairments. Rather, it reflects the outcome of numerous personal characteristics, psychophysiology, and choices, expressed throughout one's lifespan, unfolding in dynamic interaction with a complicated socio-cultural and physical environment. Participants that used psychedelic medicines described improvement of medical and mental health conditions, social interaction, spirituality, and overall function. In general, quality of life and wellness consequently improved after the use of these medicines based on established multidimensional factors. Conclusion: The use of various psychedelic medicines appears to be associated with a broad range of qualitative experiences that could help clarify the mechanism of how they impact wellness in the future.

show abstract

Section: Introductionmentioning

confidence: 99%

A Retrospective Study to Determine the Impact of Psychedelic Therapy for Dimensional Measures of Wellness: A Qualitative Analysis of Response Data

Virgilio

Minerbi

Fletcher

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…While the analgesic effects of alcohol have been known for some time ( Thompson et al, 2017 ; Cucinello-Ragland and Edwards, 2021 ), excessive alcohol exposure damages elements of the peripheral nervous system producing a characteristic small fiber painful neuropathy ( Maiya and Messing, 2014 ), and the resulting increased nociceptive sensitivity (termed hyperalgesia) is hypothesized to contribute to an increased motivational drive to drink ( Egli et al, 2012 ). In addition to the direct effects of alcohol, abstinence from heavy drinking can also increase affective pain sensitivity (termed hyperkatifeia) as part of a larger motivational withdrawal syndrome ( Edwards et al, 2012 ; Koob, 2021 ) that may also promote the use of alcohol for affective/emotional pain management.…”

Section: Mechanisms Implicated In Alcohol-human Immunodeficiency Virus Interactions Increasing Risk and Pathogenesis Of Cardiometabolic Smentioning

confidence: 99%

Pathophysiological Consequences of At-Risk Alcohol Use; Implications for Comorbidity Risk in Persons Living With Human Immunodeficiency Virus

2022

Self Cite

View full text Add to dashboard Cite

At-risk alcohol use is a significant risk factor associated with multisystemic pathophysiological effects leading to multiorgan injury and contributing to 5.3% of all deaths worldwide. The alcohol-mediated cellular and molecular alterations are particularly salient in vulnerable populations, such as people living with HIV (PLWH), diminishing their physiological reserve, and accelerating the aging process. This review presents salient alcohol-associated mechanisms involved in exacerbation of cardiometabolic and neuropathological comorbidities and their implications in the context of HIV disease. The review integrates consideration of environmental factors, such as consumption of a Western diet and its interactions with alcohol-induced metabolic and neurocognitive dyshomeostasis. Major alcohol-mediated mechanisms that contribute to cardiometabolic comorbidity include impaired substrate utilization and storage, endothelial dysfunction, dysregulation of the renin-angiotensin-aldosterone system, and hypertension. Neuroinflammation and loss of neurotrophic support in vulnerable brain regions significantly contribute to alcohol-associated development of neurological deficits and alcohol use disorder risk. Collectively, evidence suggests that at-risk alcohol use exacerbates cardiometabolic and neurocognitive pathologies and accelerates biological aging leading to the development of geriatric comorbidities manifested as frailty in PLWH.

show abstract

“…20 This identifies the potential risk involved in consuming alcohol for analgesic purposes. 21 Furthermore, authors from an empirical study examining the interaction of pain and alcohol-induced analgesia found that hazardous drinkers (determined by AUDIT-C scores) had a greater urge and intention to drink alcohol when given experimentally induced pain compared to hazardous drinkers without pain induction. 22 This highlights an important motivational aspect of drug-induced analgesia, where acute pain can increase the desire to drink alcohol or take opioids as an active strategy for reducing pain and associated negative emotional states.…”

Section: Pain Relief As Negative Reinforcement In Sudmentioning

confidence: 99%

The Convergent Neuroscience of Affective Pain and Substance Use Disorder

Pahng

Edwards

2021

ARCR

View full text Add to dashboard Cite

Opioids and alcohol are widely used to relieve pain, with their analgesic efficacy stemming from rapid actions on both spinal and supraspinal nociceptive centers. As an extension of these relationships, both substances can be misused in attempts to manage negative affective symptoms stemming from chronic pain. Moreover, excessive use of opioids or alcohol facilitates the development of substance use disorder (SUD) as well as hyperalgesia, or enhanced pain sensitivity. Shared neurobiological mechanisms that promote hyperalgesia development in the context of SUD represent viable candidates for therapeutic intervention, with the ideal strategy capable of reducing both excessive substance use as well as pain symptoms simultaneously. Neurocognitive symptoms associated with SUD, ranging from poor risk management to the affective dimension of pain, are likely mediated by altered activities of key anatomical elements that modulate executive and interoceptive functions, including contributions from key frontocortical regions. To aid future discoveries, novel and translationally valid animal models of chronic pain and SUD remain under intense development and continued refinement. With these tools, future research strategies targeting severe SUD should focus on the common neurobiology between negative reinforcement and affective elements of pain, possibly by reducing excessive stress hormone and neurotransmitter activity within shared circuitry.

show abstract

Neurobiological aspects of pain in the context of alcohol use disorder

Cited by 18 publications

References 173 publications

A Retrospective Study to Determine the Impact of Psychedelic Therapy for Dimensional Measures of Wellness: A Qualitative Analysis of Response Data

A Retrospective Study to Determine the Impact of Psychedelic Therapy for Dimensional Measures of Wellness: A Qualitative Analysis of Response Data

Pathophysiological Consequences of At-Risk Alcohol Use; Implications for Comorbidity Risk in Persons Living With Human Immunodeficiency Virus

The Convergent Neuroscience of Affective Pain and Substance Use Disorder

Contact Info

Product

Resources

About