Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, USA.
NIGMS, Bethesda, MD, USA.
Psychopharmacology (Berl). 2021 Jul;238(7):1885-1897. doi: 10.1007/s00213-021-05816-9. Epub 2021 Mar 25.
Pain-related factors increase the risk for opioid addiction, and pain may function as a negative reinforcer to increase opioid taking and seeking. However, experimental pain-related manipulations generally do not increase opioid self-administration in rodents. This discrepancy may reflect insufficient learning of pain-relief contingencies or confounding effects of pain-related behavioral impairments. Here, we determined if pairing noxious stimuli with opioid self-administration would promote pain-related reinstatement of opioid seeking or increase opioid choice over food.
In Experiment 1, rats self-administered fentanyl in the presence or absence of repeated intraplantar capsaicin injections in distinct contexts to model context-specific exposure to cutaneous nociception. After capsaicin-free extinction in both contexts, we tested if capsaicin would reinstate fentanyl seeking. In Experiment 2, rats self-administered heroin after intraperitoneal (i.p.) lactic acid injections to model acute visceral inflammatory pain. After lactic acid-free extinction, we tested if lactic acid would reinstate heroin seeking. In Experiment 3, we tested if repeated i.p. lactic acid or intraplantar Complete Freund's Adjuvant (CFA; to model sustained inflammatory pain) would increase fentanyl choice over food.
In Experiments 1-2, neither capsaicin nor lactic acid reinstated opioid seeking after extinction, and lactic acid did not increase heroin-induced reinstatement. In Experiment 3, lactic acid and CFA decreased reinforcement rate without affecting fentanyl choice.
Results extend the range of conditions across which pain-related manipulations fail to increase opioid seeking in rats and suggest that enhanced opioid-addiction risk in humans with chronic pain involves factors other than enhanced opioid reinforcement and relapse.
与疼痛相关的因素会增加阿片类药物成瘾的风险,而疼痛可能作为一种负强化物,增加阿片类药物的摄取和寻求。然而,实验性疼痛相关操作通常不会增加啮齿动物的阿片类药物自我给药。这种差异可能反映了对疼痛缓解的条件作用学习不足,或者疼痛相关行为障碍的混杂影响。在这里,我们确定了将有害刺激与阿片类药物自我给药相结合是否会促进与疼痛相关的阿片类药物寻求的恢复,或者增加阿片类药物对食物的选择。
在实验 1 中,大鼠在存在或不存在反复足底皮下注射辣椒素的不同环境中自我给予芬太尼,以模拟对皮肤伤害感受的特定环境暴露。在两种环境中无辣椒素消退后,我们测试了辣椒素是否会恢复芬太尼的寻求。在实验 2 中,大鼠在腹腔内(i.p.)乳酸注射后自我给予海洛因,以模拟急性内脏炎症性疼痛。在乳酸无消退后,我们测试了乳酸是否会恢复海洛因的寻求。在实验 3 中,我们测试了反复腹腔内乳酸或足底完全弗氏佐剂(CFA;模拟持续炎症性疼痛)是否会增加芬太尼对食物的选择。
在实验 1-2 中,无论是辣椒素还是乳酸都没有在消退后恢复阿片类药物的寻求,而且乳酸也没有增加海洛因引起的恢复。在实验 3 中,乳酸和 CFA 降低了强化率,而不影响芬太尼的选择。
结果扩展了疼痛相关操作在大鼠中未能增加阿片类药物寻求的条件范围,并表明慢性疼痛患者的阿片类药物成瘾风险增加涉及其他因素,而不仅仅是增强了阿片类药物的强化和复燃。