Opioids Could Affect Brain’s Response to Reward in FM Patients, Study Suggests

Opioids Could Affect Brain’s Response to Reward in FM Patients, Study Suggests
The use of opioid painkillers might affect brain activity associated with responses of anticipated rewards and non-punishments in people with fibromyalgia, a pilot study suggests. This finding could help clinicians better understand the impact of long-term opioid use for the treatment of chronic pain. The study, “Apparent Effects of Opioid Use on Neural Responses to Reward in Chronic Pain,” was published in the journal Nature Scientific Reports. People with chronic pain, such as those affected by fibromyalgia, often develop kinesophobia — a fear or avoidance of moving. For many of them, physical activity leads to pain, which will cause them to decrease their physical activity to avoid additional pain. This can be viewed as a maladaptive cycle of punishment (or pain) and reward (pain avoidance). This is a barrier to treating these patients and improving their physical function and quality of life. A better understanding of the underlying neural mechanisms involved in this reward and punishment response can help develop better strategies to reduce or break the cycle. While chronic pain can change the neural networks implicated in incentive processing, such as by reducing the activity of some brain circuits, painkillers (such as opioids) can also have an impact on these responses. Current guidelines do not recommend the use of opioids to treat fibromyalgia because of myriad  side effects, risk of addiction, and poor evidence of effectiveness. Still, many patients who take them report benefits similar to those of patients taking non-opioid painkillers. Researchers from
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