Cited by 166Neuropeptides and Animal PhysiologyNeurotransmitter Receptor Influence on BehaviorPain Mechanisms and Treatments

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Understanding How Opioids Contribute to Reward and Analgesia

Fields, Howard L.·2007·Regional Anesthesia and Pain Medicine

DOI 10.1097/00115550-200705000-00012

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Abstract

Opioids acting at the mu opioid (MOP) receptor produce powerful analgesia. They also produce an intensely rewarding effect that can lead to addiction. The analgesic effect of MOP receptor agonists derives from a direct inhibitory effect on pain transmission at the spinal-cord level and through activation of a descending pain-modulatory pathway. The rewarding effect of MOP agonists is the result of their actions in the mesostriatal dopamine pathway classically associated with both natural and drug rewards. Both the analgesic and rewarding effect of MOP agonists are best understood in the context of decision making under conditions of conflict. Pain is one of many competing motivational states, and endogenous opioids suppress responses to noxious stimuli in the presence of conflicting motivations, such as hunger or a threatening predator. When a food reward is available, MOP agonists microinjected into the mesostriatal circuit promote its consumption, while concomitantly suppressing responses to noxious stimulation. The mesostriatal "reward" circuit, thus, appears to perform a function critical to decision making and can either amplify or suppress responses to noxious stimuli.

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Authors: Fields, H. L.
Affiliations: University of California, San Francisco (US)
Corresponding author: Fields, Howard L.
ORCID: Fields, Howard L.
Venue: Regional Anesthesia and Pain Medicine
Publisher: BMJ
Published: 2007-05
Volume: 32
Issue: 3
Pages: 242-246
ISSN: 1098-7339 (ISSN-L)
DOI: 10.1097/00115550-200705000-00012
OpenAlex: W2057241840
Cited by: 166
References: 38
Citations by year: 2026: 4 · 2025: 9 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 9 · 2018: 7 · 2017: 11 · 2016: 19 · 2015: 14 · 2014: 14 · 2013: 16 · 2012: 11
FWCI: 2.63
Type: journal article
Language: en
Open access: closed
Locations: Regional Anesthesia & Pain Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords: opioids, mu-opioid receptor, analgesia, reward, descending pain modulation, opioid use disorder, decision-making, motivational conflict, food reward, endogenous opioids, noxious stimuli
MeSH terms: Analgesics, Opioid, Animals, Conflict, Psychological, Decision Making, Dopamine, Escape Reaction, Feeding Behavior, Humans, Medulla Oblongata, Motivation, Narcotic Antagonists, Opioid-Related Disorders, Nucleus Accumbens, Pain, Periaqueductal Gray, Reward, Spinal Cord, Behavior, Addictive, Receptors, Opioid, mu, Opioid Peptides

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Understanding How Opioids Contribute to Reward and Analgesia

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