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Common Brain Mechanisms of Chronic Pain and Addiction
Open accessAbstract
While chronic pain is considered by some to be a CNS disease, little is understood about underlying neurobiological mechanisms. Addiction models have heuristic value in this regard, because both pain and addictive disorders are characterized by impaired hedonic capacity, compulsive drug seeking, and high stress. In drug addiction such symptomatology has been attributed to reward deficiency, impaired inhibitory control, incentive sensitization, aberrant learning, and anti-reward allostatic neuroadaptations. Here we propose that similar neuroadaptations exist in chronic pain patients.
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“better social support was associated with less postoperative pain after surgical management of breast cancer in a recent meta-analysis 97.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [97]
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“This theory suggests that repeated use of illicit drugs induces neuroadaptations leading to enduring sensitization of dopamine systems with subsequent hyperreactivity in response to drug cues and a pathological degree of incentive salience, manifesting as a disproportionate motivation to pursue the drug (16, 18, 19).”
From Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice (2019) · cites this paper as [16]
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Metadata
- Authors
- Elman, I., & Borsook, D.
- Affiliations
- Wright State University (US)
- Boston Children's Hospital (US)
- Corresponding author
- Elman, Igor
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 89
- Issue
- 1
- Pages
- 11-36
- ISSN
- 0896-6273 (ISSN-L)
- OpenAlex
- W2228504785
- Cited by
- 303
- References
- 294
- Citations by year
- 2026: 13 · 2025: 26 · 2024: 33 · 2023: 24 · 2022: 37 · 2021: 38 · 2020: 34 · 2019: 36 · 2018: 30 · 2017: 18 · 2016: 14
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (K24NS064050)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, addiction, neural adaptation, incentive sensitization, inhibitory control, compulsive drug seeking, hedonic capacity, stress
- MeSH terms
- Animals, Brain, Humans, Reward, Behavior, Addictive, Substance-Related Disorders, Drug-Seeking Behavior, Chronic Pain
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