Allostatic changes in neurocircuitry following repeated opioid exposure in OUD. Following repeated opioid use, allostatic changes are observed in circuitry that mediates reward and motivation (a switch from “liking” to “wanting”), stress and negative affect (decreases in anti-stress; increases in stress), as well as cognitive function (decreases in executive function, and increased incentive sensitization to drug cues); Amy, amygdala; dlPFC, dorsal lateral PFC; DS, Dorsal striatum; Hipp, hippocampus; Hypothal, hypothalamus; NAc, nucleus accumbens; OFC, orbitofrontal cortex; vlPFC, ventral lateral PFC; vmPFC, ventral medial PFC; VP, ventral pallidum; VTA, ventral tegmental area. Figure created with Biorender.com.