# Stress and Opioid Misuse Risk: The Role of Endogenous Opioid and Endocannabinoid Mechanisms > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/stress-induced-opioid-misuse-mechanisms-clinical-trial/ > **Published:** 2026-05-08T15:04:56-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T17:16:01-04:00 > **Clinical Summary:** Clinical trial examining stress induced opioid misuse mechanisms in chronic back pain patients reveals endocannabinoid pathways' role in addiction risk. --- CED Clinical Relevance  #84High Clinical Relevance  Strong evidence or policy relevance with direct clinical implications. 🧪 Clinical Trial Watch  |  CED Clinic Trial ID NCT05142267 Status Recruiting Condition Opioid Use Disorder Intervention Placebo Why This Matters This trial addresses the critical intersection of stress, [pain management](https://cedclinic.com/cbd-cbg-topicals-for-eczema/), and opioid misuse risk—a gap in our understanding that has profound implications for prescription practices. By examining how stress modulates opioid effects through endogenous opioid and endocannabinoid pathways, it could inform safer prescribing strategies for patients with [chronic pain](https://cedclinic.com/cannabinoids-pain-management-opioid-alternative/). Clinical Summary NCT05142267 is a recruiting interventional trial investigating stress-induced changes in opioid medication effects among patients with back pain. The study examines how acute stress exposure influences opioid response and misuse potential, with particular focus on endogenous opioid and [endocannabinoid system](https://cedclinic.com/endocannabinoid-system-fear-extinction/) interactions. Primary endpoints likely include subjective drug effects, physiological responses, and behavioral measures of misuse liability under stressed versus non-stressed conditions. Dr. Caplan’s Take “If this trial demonstrates that stress significantly amplifies opioid misuse risk through measurable biological pathways, I could incorporate stress assessment and mitigation strategies into my [pain management](https://cedclinic.com/cbd-cbg-topicals-for-eczema/) protocols. This mechanistic understanding would strengthen my clinical rationale for recommending cannabis-based alternatives in high-stress patients requiring [chronic pain management](https://cedclinic.com/cannabinoids-in-reward-processing-pain-perception/).” Clinical Perspective 🧠 Patients with [chronic pain](https://cedclinic.com/cannabinoids-pain-management-opioid-alternative/) and high stress levels should understand that their stress state may influence how they respond to opioid medications. Clinicians should consider this trial’s eventual findings when evaluating opioid prescription decisions, particularly for patients with identifiable stress factors or trauma histories. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Stress%20and%20Opioid%20Misuse%20Risk%3A%20The%20Role%20of%20Endogenous%20Opioid%20and%20Endocannabinoid...%20%40drcaplan&url=https%3A//clinicaltrials.gov/study/NCT05142267)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//clinicaltrials.gov/study/NCT05142267)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Stress%20and%20Opioid%20Misuse%20Risk%3A%20The%20Role%20of%20Endogenous%20Opioid%20and%20Endocannabinoid...%20--%20via%20%40drcaplan.bsky.social%20https%3A//clinicaltrials.gov/study/NCT05142267)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://clinicaltrials.gov/study/NCT05142267](https://clinicaltrials.gov/study/NCT05142267) Table of Contents - [FAQ](#FAQ)[What is trial NCT05142267 about?](#What_is_trial_NCT05142267_about) - [Why does this opioid trial involve the endocannabinoid system?](#Why_does_this_opioid_trial_involve_the_endocannabinoid_system) - [What outcomes will the stress and opioid trial likely measure?](#What_outcomes_will_the_stress_and_opioid_trial_likely_measure) - [Has the stress and opioid trial reported any results yet?](#Has_the_stress_and_opioid_trial_reported_any_results_yet) - [Related](#Related) ## FAQ ### What is trial NCT05142267 about? It is an interventional trial investigating stress-induced changes in how opioid medications affect patients with back pain. The trial listing names opioid use disorder as the condition being studied, and the research centers on whether stress alters the effects of opioid medication in this patient group. ### Why does this opioid trial involve the endocannabinoid system? The trial examines how acute stress exposure influences opioid response and misuse potential, with particular focus on interactions between the endogenous opioid system and the [endocannabinoid system](https://cedclinic.com/endocannabinoid-system-fear-extinction/). In other words, it looks at whether these two systems in the body are involved in how stress changes the way opioid medications act. ### What outcomes will the stress and opioid trial likely measure? According to the article, the primary endpoints likely include subjective drug effects, physiological responses and behavioral measures of misuse liability. These would be compared under stressed versus non-stressed conditions to see how stress shapes the response to opioid medication. ### Has the stress and opioid trial reported any results yet? Not yet. The trial is listed as recruiting, meaning it is still enrolling participants, so no findings have been reported. Until results are available, it cannot show whether stress changes how opioid medications affect people with back pain. [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).