Recent developments in opiate research and their implications for psychiatry

Considerable progress in opiate research has been made during the last few years regarding the identification and localization of opiate receptors in vitro and in vivo, the analysis of drug-receptor interactions and the characterization of an endogenous ligand of the opiate receptor. There is little evidence that effects induced by chronic exposure to opiates - development of tolerance and dependence -are due to changes in opiate receptor mechanisms; it is supposed that the adaptive changes occur mainly in the chain of events triggered by the drug-receptor interaction. Such changes may be directly or indirectly related to the metabolism of neurotransmitters and/or cyclic nucleotides. The obvious links between physical and psychic equivalents of opiate dependence are discussed. Present data points to the significance of brain stem and limbic structures in both these processes, monoamines probably playing an important role. Relations between psychic manifestations of opiate addiction and mental disorders are pointed out.