Deficits in autonomic indices of emotion regulation and reward processing associated with prescription opioid use and misuse

Eric L. Garland, Craig J. Bryan, Yoshio Nakamura, Brett Froeliger, Matthew O. Howard

Research output: Research - peer-reviewArticle

Abstract

Rationale: Prescription opioid misuse and high-dose opioid use may result in allostatic dysregulation of hedonic brain circuitry, leading to reduced emotion regulation capacity. In particular, opioid misuse may blunt the ability to experience and upregulate positive affect from natural rewards. Objectives: The purpose of this study was to examine associations between opioid use/misuse and autonomic indices of emotion regulation capability in a sample of chronic pain patients receiving prescription opioid pharmacotherapy. Methods: Chronic pain patients taking long-term opioid analgesics (N = 40) completed an emotion regulation task while heart rate variability (HRV) was recorded, and also completed self-report measures of opioid misuse, craving, pain severity, and emotional distress. Based on a validated cut-point on the Current Opioid Misuse Measure, participants were grouped as opioid misusers or non-misusers. Opioid misuse status and morphine equivalent daily dose (MEDD) were examined as predictors of HRV and self-reports of emotion regulation. Results: Opioid misusers exhibited significantly less HRV during positive and negative emotion regulation, and significantly less positive effect, than non-misusers, after controlling for confounders including pain severity and emotional distress. MEDD was inversely associated with positive emotion regulation efficacy. Conclusion: Findings implicate the presence of reward processing deficits among chronic pain patients with opioid-misusing behaviors, and opioid dosage was associated with deficient emotion regulation, suggesting the presence of compromised top-down cognitive control over bottom-up hedonic processes. Emotion regulation among opioid misusers may represent an important treatment target.

LanguageEnglish (US)
Pages621-629
Number of pages9
JournalPsychopharmacology
Volume234
Issue number4
DOIs
StatePublished - Feb 1 2017

Fingerprint

Reward
Opioid Analgesics
Prescriptions
Emotions
Chronic Pain
Heart Rate
Pleasure
Self Report
Morphine
Pain
Aptitude
Up-Regulation
Drug Therapy
Brain
Therapeutics
Craving

Keywords

  • Allostatic
  • Chronic pain
  • Emotion regulation
  • Heart rate variability
  • Opioid misuse
  • Reward

ASJC Scopus subject areas

  • Pharmacology

Cite this

Deficits in autonomic indices of emotion regulation and reward processing associated with prescription opioid use and misuse. / Garland, Eric L.; Bryan, Craig J.; Nakamura, Yoshio; Froeliger, Brett; Howard, Matthew O.

In: Psychopharmacology, Vol. 234, No. 4, 01.02.2017, p. 621-629.

Research output: Research - peer-reviewArticle

Garland, Eric L. ; Bryan, Craig J. ; Nakamura, Yoshio ; Froeliger, Brett ; Howard, Matthew O./ Deficits in autonomic indices of emotion regulation and reward processing associated with prescription opioid use and misuse. In: Psychopharmacology. 2017 ; Vol. 234, No. 4. pp. 621-629
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