Does childhood adversity alter opioid drug reward? A conceptual replication in outpatients before surgery

Abstract

Introduction

Opioid analgesic treatment during surgery entails the risk of persistent use. Experiences of childhood adversity have been shown to increase opioid reward in preclinical models, a finding recently extended to healthy humans. We tested whether childhood adversity similarly increased opioid reward, operationalized as drug-induced feeling good and drug liking, in outpatients receiving opioids on the operating table.

Methods

This observational study recruited patients entering a Norwegian hospital for an outpatient surgical procedure. An opioid intravenous opioid analgesic (remifentanil [Minto model, effect-site concentration: 5 ng/ml], or oxycodone [5 mg]) was administered in the minutes before general anesthesia. Verbal numerical ratings of feeling good and anxious were collected 1 min before, and 1–3 min after opioid infusion. Ratings of drug liking, disliking, and feeling high were also collected after infusion. Patients (n = 151) completed measures of childhood adversity at a later date.

Results

Regression analyses revealed a modest yet significant negative association between childhood adversity and post-opioid liking (b = −0.06, p = 0.046) but no significant effect on feeling good (b = 0.01, p = 0.690) after the pre-operative opioid dose. Exploratory analyses showed that more childhood adversity was significantly associated with higher reports of anxiety, depression, loneliness, and pain catastrophising, however not with alcohol or other drug use, or with any other subjective drug effects.

Discussion

Ratings of feeling good and drug liking of medically prescribed opioids given before surgery were not higher after childhood adversity, and previous findings were not conceptually replicated. The discrepancy between current and prior results may be due to the context and stress related to the impending surgery, the short duration of drug exposure, and the relatively limited levels of high childhood adversity in the current sample compared to the original study. Exploratory analysis was consistent with the possibility of a nonlinear relationship between positive opioid effects and childhood adversity scores. Future research should assess the link between childhood adversity, subjective effects, and use of the prescribed opioids after surgery.

Keywords:

• Childhood trauma
• childhood adversity
• opioids
• pleasure
• liking
• subjective effects
• reward
• analgesics
• surgery
• oxycodone
• remifentanil

Author contributions

ME, SL, MK, and MC conceptualized this study, while ME, SL, and GE conceptualized the broader research trial. MK, IMM, KB, and ENJ conducted the data curation. MC and MK conducted the formal analyses, supported by ME and MT. SL acquired the funding as part of the broader trial. MC and MKK completed data visualization. MC, MK, ME and SL wrote the original draft. IMM, MT, KB, ENJ, and GE reviewed and edited. MC and MK contributed equally and share the first authorship.

Disclosure statement

No potential conflict of interest was reported by the author(s)

Open Scholarship

This article has earned the Center for Open Science badges for Open Materials and Preregistered. The materials are openly accessible at https://osf.io/2sp9z and https://doi.org/10.17605/OSF.IO/XR2VB.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by grants awarded to SL as part of the broader research trial by the European Research Council under the EU Horizon 2020 research and innovation programme (grant no. 802885) and South-Eastern Norway Regional Health Authority (grant no. 2020087).