New Opioid Receptor Modulators and Agonists: Relevance for Pain and Opioid Use Disorder Management | Ch 6

Document Type

Book Chapter

Publication Date

9-26-2025

Editor

Scott Edwards et al

Abstract

The analgesic efficacy of opioids is well known, and opioids represent a crucial medication strategy for the treatment of specific pain conditions. However, opioids were until very recently overprescribed for multiple chronic pain conditions, leading to the emergence of several clinical risks. Excessive use of opioids leads not only to analgesic tolerance, but the emergence of a paradoxical hyperalgesia, or exaggerated nociceptive signaling. Opioid misuse may also facilitate the development or progression of opioid use disorder (OUD) in vulnerable individuals. From a psychological perspective, chronic and unrelieved pain is intimately associated with negative affect, and opioid-induced hyperalgesia may constitute a specific condition closely associated with the transition to OUD through facilitation of negative reinforcement processes. Recent insights into the neurobiological mechanisms that promote the analgesic versus pain-facilitating properties of opioids have provided a unique conceptual basis for OUD, and current preclinical and translational work is dedicated to the discovery of safer alternatives to opioid analgesia as well as more effective therapeutic strategies that might simultaneously combat chronic pain and OUD.

First Page

51

Last Page

61

Chapter Title

Chapter 6 - The balance of pain treatment and pain facilitation by opioids: Relevance for opioid use disorder risk

Publisher

Academic Press

ISBN

[9780443265051, 9780443265044]

Rights

Copyright © 2026 Elsevier Inc.

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