Selected opioids modify intake of sweetened ethanol solution among female rats

Sigma receptor-induced heavy drinking in rats: Modulation by the opioid receptor system

Alcohol use disorder (AUD) is a major cause of morbidity and mortality worldwide, for which new efficacious treatments are necessary. The opioid receptor system is a mediator of the rewarding effects of alcohol; in particular, while activation of μ opioid receptors enhances ethanol intake in rodents, opioid-receptor antagonists, such as naloxone and naltrexone, reduce its pleasurable and reinforcing effects, thereby decreasing alcohol. Sigma receptors (Sig-Rs) have been proposed as modulators of the effects of alcohol and, therefore, as a potential new pharmacological target for AUD. Somewhat analogously to μ opioid ligands, SigR agonists increase, while SigR antagonists decrease alcohol intake in animal models of excessive alcohol drinking. However, a potential cross-talk between these two receptor systems in relation to alcohol consumption has so far not been investigated. Here, we addressed this question pharmacologically, by testing the effects of either activating or inhibiting opioid receptors on the heavy alcohol drinking induced by chronic stimulation of SigR in alcohol-preferring rats. We found that the opioid receptor agonist morphine, which per se increases ethanol intake, at a sub-threshold dose reduces the binge-like drinking induced by the repeated treatment with the SigR agonist 1,3-di-o-tolylguanidine (DTG); conversely, the opioid receptor antagonist naltrexone, which per se reduces ethanol intake, at a sub-threshold dose potentiates the DTG-induced binge-like drinking. Our data show a cross-talk between the opioid and SigR systems relevant to the modulation of alcohol drinking, which provides important insights into the neurobiology of AUD and may lead to the development of novel therapies, either standalone or in combination.

Pharmacotherapeutic management of co-morbid alcohol and opioid use

Opioid use disorder (OUD) and alcohol use disorder (AUD) are two highly prevalent substance-related disorders worldwide. Co-use of the substances is also quite prevalent, yet there are no pharmacological treatment approaches specifically designed to treat co-morbid OUD and AUD. Here, the authors critically summarize OUD, AUD and opioid/alcohol co-use and their current pharmacotherapies for treatment. They also review the mechanisms of action of opioids and alcohol within the brain reward circuitry and discuss potential combined mechanisms of action and resulting neuroadaptations. Pharmacotherapies that aim to treat AUD or OUD that may be beneficial in the treatment of co-use are also highlighted. Preclinical models assessing alcohol and opioid co-use remain sparse. Lasting neuroadaptations in brain reward circuits caused by co-use of alcohol and opioids remains largely understudied. In order to fully understand the neurobiological underpinnings of alcohol and opioid co-use and develop efficacious pharmacotherapies, the preclinical field must expand its current experimental paradigms of 'single drug' use to encompass polysubstance use. Such studies will provide insights on the neural alterations induced by opioid and alcohol co-use, and may help develop novel pharmacotherapies for individuals with co-occurring alcohol and opioid use disorders.

Differences in delta- and mu-opioid receptor blockade measured by positron emission tomography in naltrexone-treated recently abstinent alcohol-dependent subjects

Blockade of brain mu-opioid receptor (mu-OR) and delta-opioid receptor (delta-OR) was investigated in recently abstinent alcohol-dependent subjects (N=21) maintained on naltrexone. Subjects completed a 19-day inpatient protocol, which included alcohol abstinence followed by naltrexone treatment (50 mg) on days 15-19. Blood samples were collected after the first administration of naltrexone to evaluate serum levels of naltrexone and 6-beta-naltrexol. Regional brain mu-OR binding potential (BP) and delta-OR Ki was measured using [11C]carfentanil (CAR) positron emission tomography (PET) and [11C]methyl naltrindole ([11C]MeNTI) PET, respectively, before (day 5) and during naltrexone treatment (day 18). Naltrexone inhibition of [11C]CAR BP was near maximal across all brain regions of interest with little variability across subjects (mean+SD% inhibition=94.9+4.9%). Naltrexone only partially inhibited the [11C]MeNTI Ki and there was more variability across subjects (mean+SD% inhibition=21.1+14.49%). Peak serum levels of naltrexone were positively correlated with % inhibition of delta-OR Ki in neocortex and basal ganglia. Peak serum levels of naltrexone were not correlated with % inhibition of mu-OR BP. Peak levels of 6-beta-naltrexol were not significantly correlated with % inhibition of mu-OR BP or delta-OR Ki. Thus, the FDA recommended therapeutic dose of naltrexone was sufficient to produce near complete inhibition of the mu-OR in recently abstinent alcohol dependent subjects. The lower percent inhibition of delta-OR and greater variability in delta-OR blockade by naltrexone across subjects may contribute to individual differences in treatment outcomes to naltrexone. Further investigations on the relationship between individual differences in delta-OR blockade by naltrexone and clinical outcomes should be explored.

Boosting effect of morphine on alcohol drinking is suppressed not only by naloxone but also by the cannabinoid CB1 receptor antagonist, SR 141716

The present study investigated the effect of the cannabinoid CB(1) receptor antagonist, SR 141716 (N-piperidino-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-3-pyrazole-carboxamide), on the ability of low and high doses of morphine to, respectively, augment and suppress voluntary alcohol intake in selectively bred Sardinian alcohol-preferring rats. Acute administration of a low dose of morphine (1 mg/kg, s.c.) produced a specific and marked increase in alcohol intake, which correlated with an increase in blood alcohol levels and was prevented by either SR 141716 (0.3 mg/kg, i.p.) or naloxone (0.1 mg/kg, i.p.). A higher dose (10 mg/kg, s.c.) of morphine reduced both alcohol and food intakes and produced sedation and hypomotility. The suppressant effect of morphine on alcohol intake was blocked by naloxone (0.1 mg/kg, i.p.) but not by SR 141716 (0.3 mg/kg, i.p.). These results are in agreement with those showing the ability of SR 141716 to antagonize the appetitive and positive reinforcing properties of morphine and add further support to the hypothesis of the existence of a functional link between the action of opioids and of cannabinoids.

Peripheral opioid receptors may mediate a portion of the aversive and depressant effect of EtOH: CPP and locomotor activity

Previous investigators have reported that peripheral opioid receptors (located in the gut) may produce aversive effects when activated. Opioid receptors can be activated by endogenous opioids or by-products of ethanol (EtOH) metabolism [e.g., tetrahydroisoquinolines (TIQs)]; both are stimulated following EtOH consumption. Therefore, we tested the hypothesis that a portion of the aversive or depressant effects of EtOH may be mediated through, or modulated by, peripheral opioid receptors. Conditioned place preference (CPP) and locomotor activity were the dependent variables. Prior to EtOH gavage, we antagonized the peripheral opioid receptors with methylnaltrexone (MNTX), an opioid antagonist that does not easily pass through the blood-brain barrier. The effects of EtOH were found to be dose dependent: 1.5 g/kg was hedonically neutral but depressed locomotor activity; 2.25 g/kg EtOH was aversive and also depressed locomotor activity. MNTX (32 mg/kg) treatment was rewarding and stimulated motor activity (especially during the first conditioning session). When combined, 1.5 g/kg EtOH tended to enhance the rewarding effects of MNTX whereas MNTX blocked the aversive effects of 2.25 g/kg EtOH. During the first conditioning session EtOH attenuated the motor stimulant effects of MNTX whereas MNTX antagonized the motor depressant effects of EtOH; there was little effect of MNTX on EtOH-induced motor depression during subsequent conditioning sessions. Pretreatment with various doses of MNTX (0.1, 1.0, 10.0, 32.0 mg/kg) of rats receiving 1.5 g/kg EtOH indicated the effects of MNTX were dose dependent. Drug-induced locomotor activity and time spent in the conditioned compartment were positively correlated, suggesting that both behaviors were homologous. The data suggest that peripheral opioid receptors participate in mediating or modulating a portion of the behavioral effects of EtOH.

Prognostic factors in Buprenorphine- versus methadone-maintained patients

This study a) compared the effects of buprenorphine versus methadone maintenance on benzodiazepine and alcohol use and b) evaluated the prognostic significance of gender and psychopathology and their interaction with maintenance treatment. Eighty male and 36 female patients were randomly assigned to daily sublingual buprenorphine (4 or 12 mg) or oral methadone (20 or 65 mg). Maintenance medication was not associated with significant differences in alcohol or benzodiazepine use. Rates of abstinence from illicit opioids were significantly higher for females, within the buprenorphine 4-mg group, females also had significantly better retention, lower rates of opioid-positive urine samples, and higher rates of abstinence from illicit opioids. Lifetime sedative dependence was associated with significantly better retention, decreased rates of cocaine-positive urine samples, and increased rates of cocaine abstinence; among buprenorphine- but not methadone-maintained patients, it was also associated with increased rates of abstinence from illicit opioids.

Food cravings, endogenous opioid peptides, and food intake: a review

Extensive research indicates a strong relationship between endogenous opioid peptides (EOPs) and food intake. In the present paper, we propose that food cravings act as an intervening variable in this opioid-ingestion link. Specifically, we argue that altered EOP activity may elicit food cravings which in turn may influence food consumption. Correlational support for this opioidergic theory of food cravings is provided by examining various clinical conditions (e.g. pregnancy, menstruation, bulimia, stress, depression) which are associated with altered EOP levels, intensified food cravings, and increased food intake.

A small dose of morphine leads rats to drink more alcohol and achieve higher blood alcohol concentrations

Male Sprague-Dawley rats were maintained on a daily regimen of 22 hr of fluid deprivation followed by a 2-hr opportunity to take a sweetened alcoholic beverage and water for over 6 months. During the week before the formal procedures of the experiment described herein, access to the alcoholic beverage was limited to 1.5 hr, but access to water was still for 2 hr. Intakes of ethanol, in terms of g/kg, were tabulated at 30 min for half of the rats and at 90 min for the rest. On the day of formal procedures, half of the rats of the 30- and 90-min measures were given 1 mg/kg of morphine sulfate just before the drinking session, whereas the rest received physiological saline. Morphine increased mean g/kg intakes of ethanol, as compared with controls, at 30 and 90 min. Blood alcohol levels were also increased. These data suggest that the well-documented ability of small doses of morphine to increase rats' intake of ethanol is probably not related to its ability to produce gastrointestinal effects, but rather due to its ability to modulate central motivational mechanisms associated with ingestion.

Low doses of morphine reduce voluntary alcohol consumption in rhesus monkeys

Experimental opioid modulation has been found to influence the consumption of alcohol in animals. Whereas it has generally been agreed upon that opiate antagonists reduce alcohol consumption, the results with opiate agonists are less consistent. The present study reports on the effect of low doses of morphine in 8 adult male rhesus monkeys that had a free choice in drinking water, a 16% and a 32% ethanol/water solution, (a) during continuous ad libitum access (Experiment I), and (b) after 2 days of alcohol abstinence (Experiment II). In both experiments each monkey received a single morphine injection (i.m.) in 5 different doses (0.03, 0.06, 0.17, 0.50, 1.50 mg.kg-1); each morphine injection (i.m.) was placebo-controlled in a cross-over design. Consumption was measured from 16.00 h in the afternoon (30 min after injection) to 08.30 h the next morning. In Experiment I after 0.50 and 1.50 mg.kg-1 of morphine ethanol intake and water consumption were both reduced during the first hours after injection; only ethanol intake remained reduced during the subsequent night. Effects lasted not longer than 24 h. In Experiment II, morphine administered 30 min before reintroduction of ethanol solutions reduced ethanol intake at doses of 0.17, 0.50 and 1.50 mg.kg-1; water consumption was unaffected. The reduction lasted for the subsequent night after the 2 highest doses. Records obtained of various spontaneous behavioural activities made it unlikely that the used dose range had induced some aspecific sedation; monkeys remained alert and active. The results are contradictory with studies in which low doses of morphine stimulated alcohol drinking in rats. The present results seem to support the hypothesis that at least in monkeys morphine can compensate for some effects of alcohol.

Neuropharmacology of Cocaine and Ethanol Dependence

Drug addiction includes two important characteristics, chronic compulsive or uncontrollable drug use and a withdrawal syndrome when use of the drug is stopped. Animal models for the motivational components of drug dependence have been developed allowing a systematic exploration of the neurobiological mechanisms of drug dependence. The reinforcing actions of acute cocaine as measured by intravenous cocaine self-administration appear to be mediated by the presynaptic release of dopamine in the region of the nucleus accumbens and may preferentially involve the dopamine D-1 receptor subtype. The nucleus accumbens circuitry involved in the reinforcing actions of cocaine may include the ventral pallidum and may be modulated by serotonin. Chronic cocaine produces increases in brain reward thresholds that may reflect the "dysphoria" and anhedonia associated with cocaine dependence and suggests a dysregulation of brain reward systems possibly involving dopamine. Reliable measures for the acute reinforcing effects of ethanol in nondependent animals have been established in the rat using a lever press operant and a taste habituation procedure. Important roles have been established for serotonin, GABA, dopamine, and opioids in the acute reinforcing properties of ethanol, perhaps acting on some of the same neural circuitry subsuming the reinforcing actions of other drugs of abuse. Studies of the motivational aspects of ethanol dependence have suggested a functional role for brain corticotropin-releasing factor. These results suggest that the neurobiology of drug dependence involves not only neurotransmitters that mediate the acute reinforcing properties of drugs, but also the aversive motivational and emotional aspects of drug withdrawal. Advances in our understanding of brain changes associated with the switch from acute effects to chronic actions may provide a key to our understanding of not only drug dependence, but also psychopathology such as, anxiety, and affective disorders.

Opioidergic, serotonergic, and dopaminergic manipulations and rats' intake of a sweetened alcoholic beverage

Groups of rats were maintained on a daily regimen of 22 h of water deprivation followed by a 2-h opportunity to take either water or a sweetened ethanol solution (ES). In one experiment, it was shown that previous morphine (M) dependence had no effect on initial daily intakes of fluids. After stable ES intakes were achieved, a variety of pharmacological manipulations were assessed for their effects on intake of the ES. Nalmefene, an opioid antagonist, dose-relatedly decreased intakes of ES, and was effective across days of injections. Fluoxetine (FX), a serotonergic reuptake inhibitor, also reduced ES intakes dose relatedly, and across days of injections, but the reduction was not as great as that seen with opioid antagonists. A small dose of M increased ES intakes when given in combination with an ineffective dose of FX, just as it does by itself. However, M had no effect on ES intakes in combination with an effective dose of FX. Pimozide (PIM), a dopaminergic antagonist, dose-relatedly decreased intakes of ES and water, and responding for positively reinforcing intracranial stimulation (ICS). When given in combination, M blunted PIM's reduction of ES intake, but had no effect on PIM's ability to decrease either intake of water or responding for ICS. Amphetamine did not reliably affect rats' intakes of ES across a range of doses. The data, in addition to previous work, lead to the idea that endogenous opioid systems are more salient, with respect to intake of alcoholic beverages, than the other tested neurotransmitter systems. Furthermore, the collective data suggest that a long-lasting opioid antagonist may be an effective pharmacological adjunct to other treatments for alcohol abuse and alcoholism.

Alcohol drinking in rats during and following morphine injections

Adult male Sprague-Dawley rats given daily SC injections of 2.5 mg/kg or 10 mg/kg morphine sulfate (for eight days) decreased preference for a 5% (v/v) ethanol solution, and then increased ethanol preference during the postinjection period, relative to a saline control group. These bidirectional effects were directly related to morphine dosage. The results were interpreted as supporting the theory that alcohol drinking is reinforced through its interaction with the endogenous opioid system and can compensate for deficiencies in opioid receptor activity.

Effect of naltrexone on alcohol consumption during chronic alcohol drinking and after a period of imposed abstinence in free-choice drinking rhesus monkeys

Relapse into problematic alcohol drinking is a serious problem in the treatment of alcoholism. Free-choice drinking rhesus monkeys show relapse-like behaviour after imposed abstinence of alcohol, by immediately reinitiating ethanol intake at an increased level. The relapse-like behaviour of the monkeys seems not induced by physical withdrawal, but rather argues for a resistance to extinction of ethanol-reinforced behaviour. It has been suggested that endogenous opioids play a role in the positive reinforcing effect of ethanol. In this study, the effect of the opiate antagonist naltrexone was investigated in eight adult male rhesus monkeys (Macaca mulatta) who had about 1 year experience with alcohol drinking, under two conditions: 1) (expt 1) during continuous and concurrent supply of drinking water and two ethanol/water solutions (16% and 32% (v/v], and 2) (expt 2) after 2 days of alcohol abstinence. In both experiments, each monkey received six doses of naltrexone (0.02, 0.06, 0.17, 0.5, 1.0, 1.5 mg.kg-1); each dose was paired with a placebo injection (im) in a cross-over design. Consumption was measured from 16.00 hours in the afternoon (30 min after injection) to 9.00 hours the next morning. In experiment 1 naltrexone reduced total net ethanol intake in a graded dose-dependent manner. The effect of naltrexone was apparent shortly after injection, and lasted until the following day. Consumption of drinking water was reduced only shortly after injection. In expt 2, reduction of net ethanol intake was largely restricted to the first few hours of reinitiation of alcohol drinking, i.e. the period in which the abstinence-induced increase was manifest. Consumption of drinking water was not affected by naltrexone. Naltrexone hardly influenced consumption of the non-preferred ethanol solution of 32%. It is postulated that the opioid modulation specifically interacted with positively reinforced behaviour. In expt 2 naltrexone reduced ethanol intake at a lower dose (0.17 mg.kg-1) compared to expt 1 (0.50 mg.kg-1), but net ethanol intakes however remained higher. It might be that alcohol abstinence resulted in altered opioid activity, leading to increased ethanol-seeking behaviour. The renewed presentation of ethanol solutions (also) might have stimulated reinitiation of alcohol drinking, representing conditioned incentive stimuli. The reported monkey model of relapse in alcohol drinking could be a useful tool to evaluate new hypotheses and experimental treatments with respect to human alcoholism.

D-Ala2-Met5-enkephalinamide impairs the acquisition of ethanol preference without influencing sucrose preference

The effects of subcutaneous (SC) administration of D-Ala2-Met5-enkephalinamide (DAME) (1, 10 and 100 micrograms/kg), synthetic analog of Met-enkephalin, on the acquisition of ethanol preference were studied in male Wistar rats. Under our procedural conditions, rats develop ethanol preference by a forced ethanol drinking session (conditioning session). Preconditioning administration of DAME (100 micrograms/kg) induced a reduction in ethanol consumption on the day of treatment and on subsequent testing days, but did not reliably modify later ethanol preference. Postconditioning administration of DAME (1, 10 and 100 micrograms/kg) markedly impaired the acquisition of ethanol preference. However, under the same schedule of treatment, DAME failed to affect subsequent rats' sucrose preference. These results suggest that, when administered after rats' first exposure to ethanol, DAME could interfere either with the reinforcement mechanisms of ethanol consumption induced by its intake, or with the storage of the information related to the ethanol incentive value.

Endogenous opiates: 1987

This paper is the tenth installment of our annual review of the research during the past year involving the endogenous opiate system. It covers the nonanalgesia and behavioral studies of the opiate peptides published in 1987. The specific topics this year include stress; tolerance and dependence; eating; drinking; gastrointestinal and renal activity; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical activity; locomotor activity; sex, pregnancy, and development; immunology and cancer; and other behavior.

Constant infusions of morphine and intakes of sweetened ethanol solution among rats

Previous studies have indicated that injections of small doses of morphine increase rats' intake of solutions containing ethanol when rats have a choice of either water or a solution containing ethanol. In this experiment, rats which were implanted with osmotic pumps that delivered constant infusions of morphine (0.6 mg/kg/hr across 24 days) had elevated daily intakes of ethanol, as compared to controls, from the second day of opportunity to take the alcoholic beverage until the pumps were removed. In addition, half of the rats with pumps infusing morphine also received injections of morphine (1.0 mg/kg) just before the 1.5-hr opportunity to take alcoholic beverage or water every day for 8 days. Across this 8-day period, these rats took a mean of 5.18 g of pure ethanol/kg of body weight (g/kg) during the 1.5-hr opportunity to take the alcoholic beverage. This was reliably more than the mean of 4.02 g/kg that their counterparts (having morphine pumps and receiving injections of saline) took across the same period. These data support the hypothesis that a surfeit of opioidergic ligand may potentiate drinking of alcoholic beverages.