Opioids and addiction: Emerging pharmaceutical strategies for reducing reward and opponent processes
نویسندگان
چکیده
Conventional strategies for treating opioid abuse include cognitive/behavioral therapy, maintenance therapy and managed withdrawal. These strategies deal with the addictive state, but much effort has shifted toward developing preventative measures. One approach is to reduce the rewarding properties of abused drugs, which in the case of prescription pharmaceuticals such as opioid analgesics is clearly a worthwhile endeavor. First, we will review recent studies demonstrating that mice lacking various G-protein coupled receptors and their ligands show diminished opioid reward. These studies point to considerable interdependence among different neuromodulatory systems for establishing drug reward. Thus, we will highlight the potential for combining opioids with other receptor targets to maximize analgesia and minimize reward in order to prevent the establishment of euphoric memories and opponent processes driving addiction. A more complex issue is treating opioid addicts where many physiological shifts have developed to oppose the acute drug effects. These opponent processes occur both at the cellular level (e.g. adenylate cyclase supersensitivity) and behavioral level (e.g. dysphoria and hyperalgesia). Evidence will be presented showing that even weak opioid agonists can effectively induce the intracellular process of adenylate cyclase supersensitivity. Furthermore, opioid-induced hyperalgesia, a behavioral opponent process, may manifest differently depending on the pain stimulus, and may require a priming drug dose in some cases. Environmental stress interacts with these opponent processes and drives relapse and thus, is another variable that needs to be considered in the development of innovative pharmacotherapy options for opioid addicts. q 2005 Published by Elsevier B.V. on behalf of Association for Research in Nervous and Mental Disease.
منابع مشابه
Opioid pharmaceuticals and addiction: the issues, and research directions seeking solutions.
There are few pharmaceuticals superior to opiates for the treatment of pain. However, with concerns of addiction, withdrawal and questionable efficacy for all types of pain, these compounds are far from a magical panacea for pain-relief. As it is unlikely that other classes of compounds will supersede the opioids in the very near future, it is important to both optimize current opioid therapies...
متن کاملReview. Neurobiological mechanisms for opponent motivational processes in addiction.
The conceptualization of drug addiction as a compulsive disorder with excessive drug intake and loss of control over intake requires motivational mechanisms. Opponent process as a motivational theory for the negative reinforcement of drug dependence has long required a neurobiological explanation. Key neurochemical elements involved in reward and stress within basal forebrain structures involvi...
متن کاملDynamic Thinking Approach of Non-medical Use of Pharmaceutical Opioids
The unsteady increase in using pharmaceutical opioids is a phenomenon that has existed in human societies for a long time. Furthermore, the ever-growing trend of addiction to opioids affects communities in various economic, social, and cultural aspects. Since abusing pharmaceutical opioids is a complex dynamic problem, it is extremely difficult to recognize the factors influencing this abuse. T...
متن کاملAddiction is a Reward Deficit and Stress Surfeit Disorder
Drug addiction can be defined by a three-stage cycle - binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation - that involves allostatic changes in the brain reward and stress systems. Two primary sources of reinforcement, positive and negative reinforcement, have been hypothesized to play a role in this allostatic process. The negative emotional state that drives negati...
متن کاملPrioritizing the Factors Affecting the Abuse of Pharmaceutical Opioids by Applying Topsis
Human societies have witnessed the phenomenon of ever-increasing use of pharmaceutical opioids for a long time. Moreover, cultural, social, and economic aspects in any community have undergone the negative effects of the growing tendency toward opioids addiction. Since abusing pharmaceutical opioids is a serious problem, it is important to recognize and prioritize the factors influencing this a...
متن کامل