1. Behavioral preference for viewing drug v. pleasant images predicts current and future opioid misuse among chronic pain patients.
- Author
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Moeller SJ, Hanley AW, and Garland EL
- Subjects
- Adult, Aged, Allostasis physiology, Chronic Pain drug therapy, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prognosis, Analgesics, Opioid therapeutic use, Choice Behavior physiology, Chronic Pain physiopathology, Disease Susceptibility diagnosis, Opioid-Related Disorders diagnosis, Opioid-Related Disorders physiopathology, Pattern Recognition, Visual physiology, Pleasure physiology, Reward
- Abstract
Background: The USA is currently enduring an opioid crisis. Identifying cost-effective, easy-to-implement behavioral measures that predict treatment outcomes in opioid misusers is a crucial scientific, therapeutic, and epidemiological goal., Methods: The current study used a mixed cross-sectional and longitudinal design to test whether a behavioral choice task, previously validated in stimulant users, was associated with increased opioid misuse severity at baseline, and whether it predicted change in opioid misuse severity at follow-up. At baseline, data from 100 prescription opioid-treated chronic pain patients were analyzed; at follow-up, data were analyzed in 34 of these participants who were non-misusers at baseline. During the choice task, participants chose under probabilistic contingencies whether to view opioid-related images in comparison with affectively pleasant, unpleasant, and neutral images. Following previous procedures, we also assessed insight into choice behavior, operationalized as whether (yes/no) participants correctly self-reported the image category they chose most often., Results: At baseline, the higher choice for viewing opioid images in direct comparison with pleasant images was associated with opioid misuse and impaired insight into choice behavior; the combination of these produced especially elevated opioid-related choice behavior. In longitudinal analyses of individuals who were initially non-misusers, higher baseline opioid v. pleasant choice behavior predicted more opioid misuse behaviors at follow-up., Conclusions: These results indicate that greater relative allocation of behavior toward opioid stimuli and away from stimuli depicting natural reinforcement is associated with concurrent opioid misuse and portends vulnerability toward future misuse. The choice task may provide important medical information to guide opioid-prescribing practices.
- Published
- 2020
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