Pain, opiates and addiction

Hunt, Stephen P.; Urch, Catherine

doi:10.1016/b0-443-07287-6/50028-x

Cited by 2 publications

(2 citation statements)

References 99 publications

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“…We observe enhanced responses to morphine in multiple behavioral measures of both reward and analgesia. Although addiction and analgesic tolerance both require chronic opiate exposure, it is generally believed that they are distinct biological phenomena (Hunt & Urch 2006). There are multiple possible substrates for PKCɛ that may modulate behavioral responses to opiates.…”

Section: Discussionmentioning

confidence: 99%

Increased response to morphine in mice lacking protein kinase C epsilon

Newton

Kim

McGeehan

et al. 2006

Genes Brain and Behavior

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The protein kinase C (PKC) family of serine-threonine kinases has been implicated in behavioral responses to opiates, but little is known about the individual PKC isozymes involved. Here, we show that mice lacking PKCe have increased sensitivity to the rewarding effects of morphine, revealed as the expression of place preference and intravenous self-administration at very low doses of morphine that do not evoke place preference or self-administration in wild-type mice. The PKCe null mice also show prolonged maintenance of morphine place preference in response to repeated testing when compared with wild-type mice. The supraspinal analgesic effects of morphine are enhanced in PKCe null mice, and the development of tolerance to the spinal analgesic effects of morphine is delayed. The density of m-opioid receptors and their coupling to G-proteins are normal. These studies identify PKCe as a key regulator of opiate sensitivity in mice.

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Section: Discussionmentioning

confidence: 99%

Increased response to morphine in mice lacking protein kinase C epsilon

Newton

Kim

McGeehan

et al. 2006

Genes Brain and Behavior

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“…Nonetheless, opioids are potentially addictive drugs. With opioid therapy, a risk exists of inciting addictive behavior through the reward circuits located in the mesocorticolimbic dopamine systems and their projections into other areas of the brain (Cheatle & O'Brien, 2011; Hunt & Urch, 2006). …”

Section: Overview Of Persistent Pain and Substance Use Disordersmentioning

confidence: 99%

Adherence Monitoring with Chronic Opioid Therapy for Persistent Pain: A Biopsychosocial-Spiritual Approach to Mitigate Risk

Matteliano

Marie

Oliver

et al. 2014

Pain Management Nursing

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Opioids represent a mainstay in the pharmacological management of persistent pain. While these drugs are intended to support improved comfort and function, the inherent risk of abuse or addiction must be considered in the delivery of care. The experience of living with persistent pain often includes depression, fear, loss, and anxiety, leading to feelings of hopelessness, helplessness, and spiritual crisis. Collectively, these factors represent an increased risk for all patients, particularly those with a past history of substance abuse or addiction. This companion article to the American Society for Pain Management Nursing (ASPMN) Position Statement on Pain Management in Patients with Substance Use Disorders (2012) focuses on the intersection of persistent pain, SUD, and chronic opioid therapy and the clinical implications of monitoring adherence with safe use of opioids for those with persistent pain. This paper presents an approach to the comprehensive assessment of persons with persistent pain when receiving opioid therapy by presenting an expansion of the biopsychosocial model to now include spiritual factors associated with pain and SUD, thus formulating a biopsychosocial-spiritual approach to mitigate risk. Key principles are provided for adherence monitoring using the biopsychosocial-spiritual assessment model developed by the authors as a means of promoting sensitive and respectful care.

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Pain, opiates and addiction

Cited by 2 publications

References 99 publications

Increased response to morphine in mice lacking protein kinase C epsilon

Increased response to morphine in mice lacking protein kinase C epsilon

Adherence Monitoring with Chronic Opioid Therapy for Persistent Pain: A Biopsychosocial-Spiritual Approach to Mitigate Risk

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