This Plenary Lecture by Siri Leknes, Norway, was recorded on 23 September 2024 at the 37th ECNP Congress in Milan, Italy.
Opioids are renowned for causing euphoria, although their main legal use is for pain relief. This talk critically examines the group-level evidence on how opioids influence feelings of reward, stress, and pain in humans, drawing on opioid drug studies in healthy and clinical populations, as well as the broader literature.
Opioid use is tightly regulated due to the risk of addiction. Perhaps for this reason, opioids are commonly regarded as the most potent painkillers. However, evidence from head-to-head trials, Cochrane reviews, and network meta-analyses does not indicate the superiority of opioids compared to non-opioid analgesics for acute or chronic non-cancer pain. Several possible reasons for the discrepancy between scientific evidence and clinical experience are discussed, including the large individual variability in opioid effects not just for pain, but also for stress and reward-related measures. New data on individual differences in opioid effects related to stress and participant sex are included. Understanding the effects of these commonly used medications on the full human experience is important to ensure correct use and to prevent unnecessary pain and addiction risk.
Views and opinions expressed in these videos are those of the presenters and do not necessarily reflect the official position of ECNP. The content of these videos should not be used in any way as the basis for treatment decisions.
