Open AccessEndogenous Opioids at the Intersection of Opioid Addiction, Pain, and Depression: The Search for a Precision Medicine Approach
Author(s) -
Michael A. Emery,
Huda Akil
Publication year - 2020
Publication title -
annual review of neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 10.219
H-Index - 241
eISSN - 1545-4126
pISSN - 0147-006X
DOI - 10.1146/annurev-neuro-110719-095912
Subject(s) - addiction , endogenous opioid , opioid , mood disorders , psychiatry , psychology , mood , medicine , neuroscience , opioid use disorder , chronic pain , depression (economics) , anxiety , receptor , economics , macroeconomics
Opioid addiction and overdose are at record levels in the United States. This is driven, in part, by their widespread prescription for the treatment of pain, which also increased opportunity for diversion by sensation-seeking users. Despite considerable research on the neurobiology of addiction, treatment options for opioid abuse remain limited. Mood disorders, particularly depression, are often comorbid with both pain disorders and opioid abuse. The endogenous opioid system, a complex neuromodulatory system, sits at the neurobiological convergence point of these three comorbid disease states. We review evidence for dysregulation of the endogenous opioid system as a mechanism for the development of opioid addiction and/or mood disorder. Specifically, individual differences in opioid system function may underlie differences in vulnerability to opioid addiction and mood disorders. We also review novel research, which promises to provide more detailed understanding of individual differences in endogenous opioid neurobiology and its contribution to opioid addiction susceptibility.