Mechanisms underlying morphine analgesic tolerance and dependence

Hiroshi Ueda1, Mutsumi Ueda

  • 1Division of Molecular Pharmacology and Neuroscience, Nagasaki University Graduate School of Biomedical Sciences, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan. ueda@nagasakiu.ac.jp

Insights

Opioid tolerance involves cellular changes and neuronal circuit adaptations. This review highlights neuronal circuit plasticity, focusing on glutamate and NMDA receptor activity, as key to understanding opioid tolerance.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Cellular Biology

Background:

  • Opioid tolerance mechanisms are complex, involving cellular adaptations like receptor desensitization.
  • Existing research primarily focuses on cellular mechanisms, potentially overlooking other contributing factors.
  • Opioid tolerance and dependence are not fully explained by cellular adaptation alone.

Purpose of the Study:

  • To review the role of neuronal circuit plasticity in opioid tolerance.
  • To explore the involvement of glutamate and NMDA receptor pathways in anti-opioid mechanisms.
  • To introduce novel methods for identifying brain regions associated with opioid tolerance.

Main Methods:

  • Literature review focusing on cellular and neuronal circuit plasticity.
  • Analysis of receptor up-regulation and down-regulation of transporters.
  • Introduction of in vivo electroporation for brain loci identification.

Main Results:

  • Neuronal circuit plasticity, specifically enhanced synaptic activity involving glutamate and NMDA receptors, contributes to opioid tolerance.
  • Up-regulation of D-serine production and down-regulation of glutamate transporters create anti-opioid effects.
  • Altered expression of molecules in neuron-glial networks may augment this anti-opioid system.

Conclusions:

  • Neuronal circuit plasticity is a critical, underemphasized component of opioid tolerance.
  • The interplay between glutamate, NMDA receptors, and neuron-glial networks forms an anti-opioid system.
  • In vivo electroporation offers a promising approach to pinpoint brain regions involved in opioid tolerance and dependence.

Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Drug Abuse and Addiction: Pharmacological Phenomena01:15

Drug Abuse and Addiction: Pharmacological Phenomena

Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...
Opioid Receptors: Overview01:22

Opioid Receptors: Overview

Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2, D-Pen5]-enkephalin or DPDPE for...
Drug Dependence01:17

Drug Dependence

Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...