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. Author manuscript; available in PMC: 2019 Dec 20.
Published in final edited form as: Prog Neuropsychopharmacol Biol Psychiatry. 2017 Aug 1;87(Pt B):255–262. doi: 10.1016/j.pnpbp.2017.07.029

Figure 1. Putative pathways from chronic pain to problematic opioid use risk.

Figure 1

Chronic pain may engender (and be perpetuated by) changes within the mesolimbic dopaminergic reward system, which overtime may alter the perception of pain and its relief. These neurobiological alterations may increase opioid abuse liability either directly or indirectly via changes in positive affective system functioning. Together, these biological mechanisms and behavioral processes may influence the likelihood to misuse, abuse, and or develop addiction to prescription opioids.