Pain, Affect, and Opioids

Description. Few people would doubt that non-pathological pain serves a useful biological function.  In this sense such pains are instrumentally (extrinsically) good.  But such pains' utility seems to depend on their being intrinsically bad.  This is the sense in which most moral philosophers think of pain as an intrinsically bad sensation.  Pathological and chronic pain, having lost its utility, is thus doubly bad.  Yet what makes pain an intrinsically bad sensation is poorly understood.  Most (maybe all) other sensations aren't intrinsically bad.  Our sensory and perceptual experiences stemming from our sensory modalities have an informative (sensory-discriminative) function.  Some of them may have a default hedonic or affective value (positive or negative — they may feel good or bad), but all seem nevertheless modifiable depending on the needs and context of the organism.  Positive or negative affect has thus a motivational and learning-theoretic role in modulating behavior.  This is why it makes sense to separate the sensory-discriminative and affective-motivational functions in sensory experiences.  Since Melzack and Casey's 1968 article, most pain researchers have also embraced this distinction (along with cognitive-behavioral function) for pain. 

This one-day workshop will concentrate on the significance of this distinction by taking a closer look at the affective-motivational aspect of pains which is the source of their intrinsic badness, and thus the main ground for pain's relevance to moral philosophy, human wellbeing, and to health professionals and researchers.  Endogenous opioid systems and midbrain dopaminergic systems have been heavily implicated in the implementation of the rewarding and punishing effects of sensory stimuli.  There is strong evidence that reward and punishment can be further decomposed into at least three distinct functions: hedonic value (positive or negative/"liking or disliking"), motivation ("wanting"), and learning (behavioral reinforcement).  Addiction is widely thought to involve malfunctioning or neural maladaptation in one or more of these functions and the underlying mechanisms.  Thus it's no surprise to find both the analgesic and addictive effects of exogenous opioid use or abuse. 

This workshop will bring experts in the role opioids play in pain and pleasure and survey their common mechanisms as well as outline the causes of the emergence of the current opioid crisis.  The focus is to bring the basic science to shed light on what can be done to address the crisis.  The ethical aspects of the crisis as well as the foundational question about where the badness of pain and the goodness of pleasure comes from will also be discussed.

Confirmed participants so far include:

• Morten Kringelbach (Oxford Neuroscience)
• Howard Fields (UCSF Psychology)
• Mark Sullivan (Univ of Washington Medical School)
• Adam Shriver (Oxford Applied Ethics),
• David Silver (UBC Applied Ethics)
• Murat Aydede (UBC Philosophy). 

Friday Nov 9, UBC Robson Square Campus (C300).