Pain and Opioid-Induced Gut Microbial Dysbiosis

Karen R Thomas* (Corresponding Author), Jacob Watt, Chuen Mong J Wu, Adejoke Akinrinoye, Sairah Amjad, Lucy Colvin, Rachel Cowe, Sylvia H Duncan, Wendy R Russell, Patrice Forget

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)
2 Downloads (Pure)


Opioid-induced dysbiosis (OID) is a specific condition describing the consequences of opioid use on the bacterial composition of the gut. Opioids have been shown to affect the epithelial barrier in the gut and modulate inflammatory pathways, possibly mediating opioid tolerance or opioid-induced hyperalgesia; in combination, these allow the invasion and proliferation of non-native bacterial colonies. There is also evidence that the gut-brain axis is linked to the emotional and cognitive aspects of the brain with intestinal function, which can be a factor that affects mental health. For example, Mycobacterium, Escherichia coli and Clostridium difficile are linked to Irritable Bowel Disease; Lactobacillaceae and Enterococcacae have associations with Parkinson's disease, and Alistipes has increased prevalence in depression. However, changes to the gut microbiome can be therapeutically influenced with treatments such as faecal microbiota transplantation, targeted antibiotic therapy and probiotics. There is also evidence of emerging therapies to combat OID. This review has collated evidence that shows that there are correlations between OID and depression, Parkinson's Disease, infection, and more. Specifically, in pain management, targeting OID deserves specific investigations.

Original languageEnglish
Article number1815
Number of pages16
Issue number8
Early online date28 Jul 2022
Publication statusPublished - 1 Aug 2022

Bibliographical note

Acknowledgments: S.H.D. and W.R.R. are supported by the Scottish Government Rural and Environmental Sciences and Analytical Services (SG-RESAS).

Funding: This research received no external funding.


  • OID
  • dysbiosis
  • faecal microbiota transplantation
  • gut homeostasis
  • gut-brain axis
  • opioid induced hyperalgesia
  • opioid-induced dysbiosis
  • opioids


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