A randomized, double-blind trial investigating the relationship between early childhood trauma and the rewarding effects of morphine.

PMID: 34155732 DOI: 10.1111 / adb.13047

Commentary

Experiences of childhood trauma (abuse and neglect) are associated with opioid use disorders and may influence opioid medication reinforcement, reward characteristics and pain responses through developmental changes in the endogenous opioid system.

This is a story that has been supported by previous clinical studies, but has not been investigated in humans without addiction.

In this study, healthy participants with or without a history of severe pediatric trauma were recruited to participate in two sessions of a randomized, double-blind, crossover design in which they received either an intramuscular active dose of morphine (0.15 mg/kg), a very low dose of control (0.01 mg/kg) The sessions were held every other week.

These sessions were held one week apart.

Physical pain thresholds and tolerance, along with acute subjective and behavioral responses over a 2.5-hour period, were measured before and after drug administration using a cold-water pressure elevation test, and the trauma group, compared with the non-trauma comparison group, liked the effects of morphine, felt more euphoric, craved more of the drug during the session, and had more nausea, dizziness, and anxiety about the effects of morphine. reported less nausea, dizziness, and aversion to the effects of morphine.

Morphine increased pain threshold and tolerance, but this did not differ between groups.

These analyses suggest that childhood trauma may make children more sensitive to the pleasurable and motivational effects of opioids, reduce their susceptibility to negative effects, and provide compelling evidence of opioid reward sensitivity.

This may explain the link between trauma and vulnerability to OUD in children, the researchers said.