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. Author manuscript; available in PMC: 2020 Apr 1.
Published in final edited form as: Curr Opin Behav Sci. 2018 Oct 30;26:69–74. doi: 10.1016/j.cobeha.2018.10.002

Figure 1:

Figure 1:

Schematic representation of pain-induced allostatic changes in all four opioid systems driving the development of negative affective states. Ultimately, the presence of these negative affect together with the persistent/chronic nociceptive component of pain and the development of opioid treatment tolerance can lead to opioid prescription misuse and increased abuse liability.