title: Allostatic dysregulation of natural reward processing in prescription opioid misuse: autonomic and attentional evidence.
abstract: Chronic pain patients who misuse prescription opioids may suffer from allostatic dysregulation of natural reward processing. Hence, this study examined whether prescription opioid misusers with chronic pain (n=72) evidenced decreased natural reward responsiveness relative to non-misusers with chronic pain (n=26). Subjects completed a dot probe task containing pain-related, opioid-related, and natural reward stimuli while attentional bias (AB) scores and heart rate variability (HRV) responses were assessed. Compared to non-misusers, misusers evidenced significantly more attenuated HRV responses to opioid, pain, and natural reward cues presented during the dot probe task. These significant between-groups differences in HRV were largest during attention to natural reward cues, but became non-significant in a sensitivity analysis controlling for opioid dosing. In addition, non-misusers evidenced an AB toward natural reward cues, whereas misusers did not. Findings suggest that opioid misusers exhibit attentional and autonomic deficits during reward processing.
authors.affiliation: University of Utah, Salt Lake City, UT, United States. Electronic address: eric.garland@socwk.utah.edu.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Garland
authors.affiliation: Medical University of South Carolina, Charleston, SC, United States.
authors.forename: Brett
authors.initials: B
authors.lastname: Froeliger
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, United States.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Howard
mesh_terms: D000328:Adult; D052636:Allostasis / Q000502:physiology*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001288:Attention / Q000502:physiology*; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003463:Cues; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009293:Opioid-Related Disorders / Q000503:physiopathology* / Q000523:psychology; D063487:Prescription Drug Misuse / Q000523:psychology*; D012201:Reward
chemical_list: D000701:Analgesics, Opioid
keywords: Attentional bias; Chronic pain; Heart-rate variability; Opioid misuse; Reward processing