Chronic Pain and Substance Use Disorders: A Brief Narrative Review of Genetic, Neurobiological, and Environmental Contributions to Comorbidity.

Journal of psychiatry and brain science Pub Date : 2025-01-01 Epub Date: 2025-06-10 DOI:10.20900/jpbs.20250003
Pamela N Romero Villela, Emma C Johnson
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Abstract

Background: Chronic pain (CP) and substance use disorders (SUDs) frequently co-occur. This brief review highlights environmental, neurobiological, and genetic sources of comorbidity of CP and SUDs, focused on alcohol, nicotine, cannabis, and opioids.

Methods: A literature search on CP and SUDs was performed using Google Scholar and PubMed. Relevant literature was summarized in a narrative review.

Results: Recent genomic studies reveal that SUDs and CP share a significant portion of genetic variance, and causal inference methods suggest that CP and SUDs have bidirectional effects on one another. CP and SUDs share multiple neurobiological pathways such as the reward and stress systems, with studies implicating important regions such as the insular and anterior cingulate cortex, the ventral tegmental area, and the nucleus accumbens. Environmental risk factors for CP and SUDs include socioeconomic background, education, and broader environmental factors such as neighborhood resources, air quality and greenspace. Social support is also a protective factor against CP and SUD diagnoses and crucial for their successful treatment and remission.

Conclusions: Promising new areas of research underlying CP and SUD comorbidity include female-specific CP conditions and substance use patterns, the role of the immune system in both SUDs and CP, and the rise of large biobanks that will further precision medicine by allowing researchers to jointly model genetic, neurobiological, and socioenvironmental factors underlying their co-occurrence. In summary, CP and SUDs are debilitating conditions with far-ranging consequences for both individuals and communities; investigating their shared etiology will result in better treatments for both.

慢性疼痛和物质使用障碍:基因、神经生物学和环境对共病的影响的简要回顾。
背景:慢性疼痛(CP)和物质使用障碍(sud)经常同时发生。本文简要回顾了CP和sud共病的环境、神经生物学和遗传来源,重点是酒精、尼古丁、大麻和阿片类药物。方法:利用谷歌Scholar和PubMed检索CP和sud相关文献。对相关文献进行综述。结果:近年来的基因组研究表明,脑脊液和脑脊液具有显著的遗传变异,因果推理方法表明脑脊液和脑脊液具有双向作用。CP和sud共享多种神经生物学通路,如奖励和压力系统,研究涉及重要区域,如岛状和前扣带皮层,腹侧被盖区和伏隔核。CP和sud的环境风险因素包括社会经济背景、教育和更广泛的环境因素,如社区资源、空气质量和绿地。社会支持也是防止CP和SUD诊断的保护因素,对其成功治疗和缓解至关重要。结论:研究CP和SUD合并症的新领域包括女性特异性CP条件和物质使用模式,免疫系统在SUD和CP中的作用,以及大型生物库的兴起,这些生物库将通过允许研究人员共同建模遗传,神经生物学和社会环境因素来进一步精准医学。总之,CP和sud是一种使人衰弱的疾病,对个人和社区都有深远的影响;调查它们共同的病因将为两者带来更好的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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