State-dependent opioid control of pain

Agonists for the mu-opioid receptor are powerful analgesics and are highly addictive; however, the contribution of the delta- and kappa-opioid and opioid receptor-like receptors to motivational states is less clear. Agonists at each receptor modulate neurons in a circuit that selectively controls nociceptive transmission. This circuit can operate in both pain-inhibiting and pain-facilitating states, and the action of opioids contributes to and is determined by the state of the circuit. There is growing evidence that the state of the circuit is determined by aversive and appetitive motivational states, and that this contributes to adaptive behavioural choice.