The Guts of the Opioid Crisis

Bidirectional interactions of the gut epithelium with commensal bacteria are critical for maintaining homeostasis within the gut. Chronic opioid exposure perturbs gut homeostasis through a multitude of neuro-immune-epithelial mechanisms, resulting in the development of analgesic tolerance, a major underpinning of the current opioid crisis. Differences in molecular mechanisms of opioid tolerance between the enteric and central pain pathways pose a significant challenge for managing chronic pain without untoward gastrointestinal effects.

Automated summary

Bidirectional interactions between the gut epithelium and commensal bacteria are crucial for maintaining gut homeostasis. Chronic opioid exposure disrupts gut homeostasis through various neuro-immune-epithelial mechanisms, leading to the development of tolerance, a major factor in the current opioid crisis. The differences in molecular mechanisms of opioid tolerance between the enteric and central pain pathways present a significant challenge in managing chronic pain without adverse gastrointestinal effects.