Restructuring Hedonic Dysregulation in Chronic Pain and Prescription Opioid Misuse: Effects of Mindfulness-Oriented Recovery Enhancement on Responsiveness to Drug Cues and Natural Rewardsedit
The allostatic model posits that chronic drug use induces hedonic homeostatic dysregulation, in which motivation to obtain natural rewards (e.g., eating, copulation, affiliation) is re-organized around seeking drug-induced reward to alleviate dysphoria . The downward shift in salience of natural reward relative to drug reward may represent a crucial tipping point leading to the loss of control over drug use that is characteristic of addiction. Heightened responsiveness to drug reward coupled with decreased responsiveness to natural reward has been observed opioid-dependent individuals [2,3], predicts opioid consumption , and may drive prescription opioid misuse and addiction . Therapies that restructure reward responsiveness from valuation of drug reward to valuation of natural reward may be an effective means of treating opioid misuse.