Evidence map›Paper›PMID 23988582›Full record

ReviewNeuroscience and biobehavioral reviews2013

The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways.

Eric L Garland, Brett Froeliger, Fadel Zeidan, Kaitlyn Partin, Matthew O Howard

Registry-linked trialOpen access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neuroscience and biobehavioral reviews, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05639712 (Understanding Opioid Use Before and After Surgery in Norway), which is not on this map. Cited by 122 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 3 pooled it
8.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05639712 phase4completednot on this mapstarted 2022, after this paper: background citation

Understanding Opioid Use Before and After Surgery in Norway: A Prospective Multicenter Study and Randomized Double-blind Controlled Study

TypeinterventionalSponsorOslo University HospitalRan2022 to 2025Enrolled1,020ConditionsOpioid Use, Affective SymptomsArmsPlacebo, Morphine 2.5 mg i.v., Morphine 5 mg i.v., Morphine 10 mg i.v., Oxycodone 2.5 mg i.v.
3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 3 syntheses or guidelines pooled it, 274 citations in OpenAlex.

  1. A Systematic Review of Black People Coping With Racism: Approaches, Analysis, and Empowerment.Perspectives on psychological science : a journal of the Association for Psychological Science · 2023
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62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 1 country.

Eric L GarlandSupportive Oncology & Survivorship Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States; College of Social Work, University of Utah, Salt Lake City, UT, United States. Electronic address: eric.garland@socwk.utah.edu.
Brett Froeliger
Fadel Zeidan
Kaitlyn Partin
Matthew O Howard
Emerald Coast Science Center · USMedical University of South Carolina · USUniversity of North Carolina at Chapel Hill · USUniversity of Utah · USWake Forest University · US

Funding

Targeting Military Opioid Misuse with Mindfulness-Oriented Recovery EnhancementR34DA037005 · NIDA · UNIVERSITY OF UTAH · PI GARLAND, ERIC LEE · 2013 to 2015
$667k
Mindfulness-Oriented Recovery Enhancement For Chronic Pain Patients Receiving OpiR03DA032517 · NIDA · FLORIDA STATE UNIVERSITY · PI GARLAND, ERIC LEE · 2011 to 2012
$74k
NIDA NIH HHS DA032517NIDA NIH HHS R03 DA032517NIDA NIH HHS R34 DA037005
6 · The paper itself

Abstract

Prescription opioid misuse and addiction among chronic pain patients are emerging public health concerns of considerable significance. Estimates suggest that more than 10% of chronic pain patients misuse opioid analgesics, and the number of fatalities related to nonmedical or inappropriate use of prescription opioids is climbing. Because the prevalence and adverse consequences of this threat are increasing, there is a pressing need for research that identifies the biobehavioral risk chain linking chronic pain, opioid analgesia, and addictive behaviors. To that end, the current manuscript draws upon current neuropsychopharmacologic research to provide a conceptual framework of the downward spiral leading to prescription opioid misuse and addiction among chronic pain patients receiving opioid analgesic pharmacotherapy. Addictive use of opioids is described as the outcome of a cycle initiated by chronic pain and negative affect and reinforced by opioidergic-dopamingeric interactions, leading to attentional hypervigilance for pain and drug cues, dysfunctional connectivity between self-referential and cognitive control networks in the brain, and allostatic dysregulation of stress and reward circuitry. Implications for clinical practice are discussed; multimodal, mindfulness-oriented treatment is introduced as a potentially effective approach to disrupting the downward spiral and facilitating recovery from chronic pain and opioid addiction.

Indexed as

Analgesics, OpioidChronic PainCognition DisordersHumansMood DisordersOpioid-Related DisordersPrescription Drug MisuseAnalgesics, OpioidAddictionAllostasisAttentional biasChronic painDefault modeMindfulnessOpioid misuseReward

Identifiers

PMID23988582
PMCPMC3967721
OpenAlexW2110728022

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.