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Goode-Romero G, Dominguez L. Descriptive molecular pharmacology of the δ opioid receptor (DOR): A computational study with structural approach. PLoS One 2024; 19:e0304068. [PMID: 38991032 PMCID: PMC11239112 DOI: 10.1371/journal.pone.0304068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 05/06/2024] [Indexed: 07/13/2024] Open
Abstract
This work focuses on the δ receptor (DOR), a G protein-coupled receptor (GPCR) belonging to the opioid receptor group. DOR is expressed in numerous tissues, particularly within the nervous system. Our study explores computationally the receptor's interactions with various ligands, including opiates and opioid peptides. It elucidates how these interactions influence the δ receptor response, relevant in a wide range of health and pathological processes. Thus, our investigation aims to explore the significance of DOR as an incoming drug target for pain relief and neurodegenerative diseases and as a source for novel opioid non-narcotic analgesic alternatives. We analyze the receptor's structural properties and interactions using Molecular Dynamics (MD) simulations and Gaussian-accelerated MD across different functional states. To thoroughly assess the primary differences in the structural and conformational ensembles across our different simulated systems, we initiated our study with 1 μs of conventional Molecular Dynamics. The strategy was chosen to encompass the full activation cycle of GPCRs, as activation processes typically occur within this microsecond range. Following the cMD, we extended our study with an additional 100 ns of Gaussian accelerated Molecular Dynamics (GaMD) to enhance the sampling of conformational states. This simulation approach allowed us to capture a comprehensive range of dynamic interactions and conformational changes that are crucial for GPCR activation as influenced by different ligands. Our study includes comparing agonist and antagonist complexes to uncover the collective patterns of their functional states, regarding activation, blocking, and inactivation of DOR, starting from experimental data. In addition, we also explored interactions between agonist and antagonist molecules from opiate and opioid classifications to establish robust structure-activity relationships. These interactions have been systematically quantified using a Quantitative Structure-Activity Relationships (QSAR) model. This research significantly contributes to our understanding of this significant pharmacological target, which is emerging as an attractive subject for drug development.
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Affiliation(s)
- Guillermo Goode-Romero
- Departamento de Fisicoquímica, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Laura Dominguez
- Departamento de Fisicoquímica, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Ndiaye NA, Shamleh SA, Casale D, Castaneda-Ouellet S, Laplante I, Robinson MJF, Samaha AN. Relapse after intermittent access to cocaine: Discriminative cues more effectively trigger drug seeking than do conditioned cues. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06614-9. [PMID: 38767684 DOI: 10.1007/s00213-024-06614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/12/2024] [Indexed: 05/22/2024]
Abstract
RATIONALE When people with drug addiction encounter cues associated with drug use, this can trigger cravings and relapse. These cues can include conditioned stimuli (CSs) signaling drug delivery and discriminative stimuli (DSs) signaling drug availability. Compared to CS effects, DS effects are less explored in preclinical studies on cue-induced relapse. OBJECTIVE We compared CS and DS effects on reward seeking following abstinence from intermittent-access cocaine (or sucrose) self-administration. METHODS During 15-20 intermittent-access sessions, rats self-administered i.v. cocaine or sucrose pellets paired with a light-tone CS. Cocaine/sucrose was available for 5-min (signalled by a light; DS+) and unavailable for 25 min (signalled by different lighting conditions; DS-), and this cycled for 4 h/session. Following abstinence, we measured cocaine/sucrose seeking under extinction triggered by CS and DS presentation, and instrumental responding reinforced by these cues. RESULTS Across intermittent-access sessions, rats increased lever pressing for cocaine or sucrose during DS+ periods and decreased responding during DS- periods. On days 2 and 21 of abstinence, only presentation of the DS+ or DS+ and CS combined elicited increased cocaine/sucrose-seeking behaviour (i.e., increased active lever presses). Presenting the DS- alongside the DS+ suppressed the increased cocaine-seeking behaviour otherwise produced by the DS+ . Finally, on day 21 of abstinence, rats showed equivalent levels of lever pressing reinforced by the DS+ , CS and by the DS+ and CS combined, suggesting comparable conditioned reinforcing value. CONCLUSIONS After intermittent self-administration, cocaine-associated DSs and CSs acquire similar conditioned reinforcing properties, but DSs more effectively trigger increases in drug seeking.
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Affiliation(s)
- Ndeye Aissatou Ndiaye
- Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, H3C 3J7, Canada
| | - Sema Abu Shamleh
- Department of Psychology, Concordia University, Montréal, QC, H3G 1M8, Canada
| | - Domiziana Casale
- Department of Psychology, Université de Montréal, Montréal, QC, H3C 3J7, Canada
| | | | - Isabel Laplante
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Mike J F Robinson
- Department of Psychology, Concordia University, Montréal, QC, H3G 1M8, Canada
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Anne-Noël Samaha
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, C.P. 6128, Succursale Centre-Ville Montréal, Montréal, Québec, H3C 3J7, Canada.
- Neural Signaling and Circuitry Research Group (SNC), Faculty of Medicine, Université de Montréal, Montréal, QC, H3C 3J7, Canada.
- Center for Interdisciplinary Research On the Brain and Learning (CIRCA), Université de Montréal, Montréal, QC, H3C 3J7, Canada.
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, H3G 1M8, Canada.
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Draime JA, Anthony AL, Moser HM. Descriptive analysis of the legal ramifications of medication diversion by pharmacy employees. J Am Pharm Assoc (2003) 2024; 64:402-407. [PMID: 37952845 DOI: 10.1016/j.japh.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Medication diversion, the act of illegally redirecting prescription drugs from their intended path, is a growing problem in the United States, with significant implications for patient safety and the integrity of the health care system. OBJECTIVE The objective of this study was to link reported diversion cases from state boards of pharmacy to state court docket records to describe the legal ramifications of medication diversion. METHODS A retrospective analysis of state board of pharmacy records and state court docket records from six states between 2016 and 2021 was completed. RESULTS A total of 207 medication diversion cases were identified and 61 of these cases were able to be linked to state court cases. The study found that pharmacy technicians were involved in the majority of cases (77.3%). The study found that medication diversion frequently occurred in community pharmacies (59.2%), involving controlled medications (87.4%). The primary reasons for medication diversion were personal use (43.7%) and undetermined motives (48.5%). Of the 61 cases linked to court cases, prevalent disciplinary actions included "misdemeanor or felony charges" (21.4%) and "jail time, suspended" (9.2%). The findings underscore the need for robust systems and protocols within health care facilities to prevent medication diversion, particularly in pharmacy settings. Measures such as implementing physical and electronic controls, addressing flaws in operations, and conducting thorough background checks during the hiring process are crucial for minimizing the risk of diversion. Furthermore, the study reveals inconsistencies in the disciplinary actions taken by state boards of pharmacy and state legal systems, indicating the need for more standardized and consistent processes for prosecuting medication diversion cases. Future research should aim to include a broader sample size and develop standardized data collection methods to further explore medication diversion and its legal implications. CONCLUSION In conclusion, addressing medication diversion requires a collaborative effort between health care facilities and regulatory bodies. By prioritizing prevention strategies and aligning disciplinary actions, the health care system can ensure patient safety, uphold professional integrity, and effectively combat medication diversion.
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Marino RAM, Venniro M. Calcitonin receptor signal: a potential target for opioid use disorder? Neuropsychopharmacology 2023; 48:1835-1836. [PMID: 37580458 PMCID: PMC10584877 DOI: 10.1038/s41386-023-01702-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Rosa A M Marino
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marco Venniro
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
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Shi Y, Chen Y, Deng L, Du K, Lu S, Chen T. Structural Understanding of Peptide-Bound G Protein-Coupled Receptors: Peptide-Target Interactions. J Med Chem 2023; 66:1083-1111. [PMID: 36625741 DOI: 10.1021/acs.jmedchem.2c01309] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The activation of G protein-coupled receptors (GPCRs) is triggered by ligand binding to their orthosteric sites, which induces ligand-specific conformational changes. Agonists and antagonists bound to GPCR orthosteric sites provide detailed information on ligand-binding modes. Among these, peptide ligands play an instrumental role in GPCR pharmacology and have attracted increased attention as therapeutic drugs. The recent breakthrough in GPCR structural biology has resulted in the remarkable availability of peptide-bound GPCR complexes. Despite the several structural similarities shared by these receptors, they exhibit distinct features in terms of peptide recognition and receptor activation. From this perspective, we have summarized the current status of peptide-bound GPCR structural complexes, largely focusing on the interactions between the receptor and its peptide ligand at the orthosteric site. In-depth structural investigations have yielded valuable insights into the molecular mechanisms underlying peptide recognition. This study would contribute to the discovery of GPCR peptide drugs with improved therapeutic effects.
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Affiliation(s)
- Yuxin Shi
- School of Chemistry and Chemical Engineering, Shaoxing University, Shaoxing 312000, China.,Department of Pathophysiology, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University, School of Medicine, Shanghai 200025, China
| | - Yi Chen
- Department of Ultrasound Interventional, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai 200433, China
| | - Liping Deng
- School of Chemistry and Chemical Engineering, Shaoxing University, Shaoxing 312000, China
| | - Kui Du
- School of Chemistry and Chemical Engineering, Shaoxing University, Shaoxing 312000, China
| | - Shaoyong Lu
- Department of Pathophysiology, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University, School of Medicine, Shanghai 200025, China.,Institute of Energy Metabolism and Health, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.,College of Pharmacy, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Ting Chen
- Department of Cardiology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
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Using Machine Learning to Predict Treatment Adherence in Patients on Medication for Opioid Use Disorder. J Addict Med 2023; 17:28-34. [PMID: 35914118 DOI: 10.1097/adm.0000000000001019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Patients receiving medication for opioid use disorder (MOUD) may continue using nonprescribed drugs or have trouble with medication adherence, and it is difficult to predict which patients will continue to do so. In this study, we develop and validate an automated risk-modeling framework to predict opioid abstinence and medication adherence at a patient's next attended appointment and evaluate the predictive performance of machine-learning algorithms versus logistic regression. METHODS Urine drug screen and attendance records from 40,005 appointments drawn from 2742 patients at a multilocation office-based MOUD program were used to train logistic regression, logistic ridge regression, and XGBoost models to predict a composite indicator of treatment adherence (opioid-negative and norbuprenorphine-positive urine, no evidence of urine adulteration) at next attended appointment. RESULTS The XGBoost model had similar accuracy and discriminative ability (accuracy, 88%; area under the receiver operating curve, 0.87) to the two logistic regression models (accuracy, 88%; area under the receiver operating curve, 0.87). The XGBoost model had nearly perfect calibration in independent validation data; the logistic and ridge regression models slightly overestimated adherence likelihood. Historical treatment adherence, attendance rate, and fentanyl-positive urine at current appointment were the strongest contributors to treatment adherence at next attended appointment. DISCUSSION There is a need for risk prediction tools to improve delivery of MOUD. This study presents an automated and portable risk-modeling framework to predict treatment adherence at each patient's next attended appointment. The XGBoost algorithm appears to provide similar classification accuracy to logistic regression models; however, XGBoost may offer improved calibration of risk estimates compared with logistic regression.
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Hasin DS, Shmulewitz D, Stohl M, Greenstein E, Aharonovich E, Petronis KR, Von Korff M, Datta S, Sonty N, Ross S, Inturrisi C, Weinberger ML, Scodes J, Wall MM. Diagnosing Prescription Opioid Use Disorder in Patients Using Prescribed Opioids for Chronic Pain. Am J Psychiatry 2022; 179:715-725. [PMID: 35702830 DOI: 10.1176/appi.ajp.21070721] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The diagnostic criteria for opioid use disorder, originally developed for heroin, did not anticipate the surge in prescription opioid use and the resulting complexities in diagnosing prescription opioid use disorder (POUD), including differentiation of pain relief (therapeutic intent) from more common drug use motives, such as to get high or to cope with negative affect. The authors examined the validity of the Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 opioid version, an instrument designed to make this differentiation. METHODS Patients (N=606) from pain clinics and inpatient substance treatment who ever received a ≥30-day opioid prescription for chronic pain were evaluated for DSM-5 POUD (i.e., withdrawal and tolerance were not considered positive if patients used opioids only as prescribed, per DSM-5 guidelines) and pain-adjusted POUD (behavioral/subjective criteria were not considered positive if pain relief [therapeutic intent] was the sole motive). Bivariate correlated-outcome regression models indicated associations of 10 validators with DSM-5 and pain-adjusted POUD measures, using mean ratios for dimensional measures and odds ratios for binary measures. RESULTS The prevalences of DSM-5 and pain-adjusted POUD, respectively, were 44.4% and 30.4% at the ≥2-criteria threshold and 29.5% and 25.3% at the ≥4-criteria threshold. Pain adjustment had little effect on prevalence among substance treatment patients but resulted in substantially lower prevalence among pain treatment patients. All validators had significantly stronger associations with pain-adjusted than with DSM-5 dimensional POUD measures (ratios of mean ratios, 1.22-2.31). For most validators, pain-adjusted binary POUD had larger odds ratios than DSM-5 measures. CONCLUSIONS Adapting POUD measures for pain relief (therapeutic intent) improved validity. Studies should investigate the clinical utility of differentiating between therapeutic and nontherapeutic intent in evaluating POUD diagnostic criteria.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Malka Stohl
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Eliana Greenstein
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Kenneth R Petronis
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Michael Von Korff
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Samyadev Datta
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Nomita Sonty
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Stephen Ross
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Charles Inturrisi
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Michael L Weinberger
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Jennifer Scodes
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
| | - Melanie M Wall
- Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia University Medical Center, New York (Sonty, Weinberger); Department of Psychiatry, New York University, New York (Ross); Cornell University Medical College, New York (Inturrisi)
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Abstract
Importance Craving, which is a strong desire for drugs, is a new DSM-5 diagnostic criterion for substance use disorders (SUDs), which are the most prevalent, costly, and deadly forms of psychopathology. Despite decades of research, the roles of drug cues and craving in drug use and relapse remain controversial. Objective To assess whether 4 types of drug cue and craving indicators, including cue exposure, physiological cue reactivity, cue-induced craving, and self-reported craving (without cue exposure), are prospectively associated with drug use and relapse. Data Sources Google Scholar was searched for published studies from inception through December 31, 2018. In addition, backward and forward searches were performed on included articles to identify additional articles. Study Selection Included studies reported a prospective statistic that linked cue and craving indicators at time 1 to drug use or relapse at time 2, in humans. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Study characteristics and statistics were extracted and/or coded by 1 of the 2 authors and then checked by the other. Statistical analyses were performed from May to July 2021. Main Outcomes and Measures Random-effects models were used to calculate prospective odds ratios (ORs) representing the association between cue and craving indicators and subsequent drug use/relapse. Results A total of 18 205 records were identified, and 237 studies were included. Across 656 statistics, representing 51 788 human participants (21 216 with confirmed SUDs), a significant prospective association of all cue and craving indicators with drug use/relapse was found (OR, 2.05; 95% CI, 1.94-2.15), such that a 1-unit increase in cue and craving indicators was associated with more than double the odds of future drug use or relapse. A Rosenthal fail-safe analysis revealed that 180 092 null studies would need to be published to nullify this finding. Trim-and-fill analysis brought the adjusted effect size to an OR of 1.31 (95% CI, 1.25-1.38). Moderator analyses showed that some of the strongest associations were found for cue-induced craving, real cues or images, drug use outcome, same-day time lag, studies using ecological momentary assessment, and male participants. Conclusions and Relevance Findings from this systematic review and meta-analysis suggest that drug cue and craving indicators play significant roles in drug use and relapse outcomes and are an important mechanism underlying SUDs. Clinically, these results support incorporating craving assessment across stages of treatment, as early as primary care.
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Affiliation(s)
- Nilofar Vafaie
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Hedy Kober
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Banks ML. Environmental influence on the preclinical evaluation of substance use disorder therapeutics. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 93:219-242. [PMID: 35341567 DOI: 10.1016/bs.apha.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Substance use disorders (SUD) develop as a result of complex interactions between the environment, the subject, and the drug of abuse. Preclinical basic research investigating each of these tripartite components of SUD individually has resulted in advancements in our fundamental knowledge regarding the progression from drug abuse to SUD and severe drug addiction and the underlying behavioral and neurobiological mechanisms. How these complex interactions between the environment, the subject, and the drug of abuse impact the effectiveness of candidate or clinically used medications for SUD has not been as extensively investigated. The focus of this chapter will address the current state of our knowledge how these environmental, subject, and pharmacological variables have been shown to impact candidate or clinical SUD medication evaluation in preclinical research using drug self-administration procedures as the primary dependent measure. The results discussed in this chapter highlight the importance of considering environmental variables such as the schedule of reinforcement, concurrent availability of alternative nondrug reinforcers, and experimental housing conditions in the context of SUD therapeutic evaluation. The thesis of this chapter is that improved understanding of environmental variables in the context of SUD research will facilitate the utility of preclinical drug self-administration studies in the evaluation and development of candidate SUD therapeutics.
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Affiliation(s)
- Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.
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10
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Bossert JM, Townsend EA, Altidor LKP, Fredriksson I, Shekara A, Husbands S, Sulima A, Rice KC, Banks ML, Shaham Y. Sex differences in the effect of chronic delivery of the buprenorphine analogue BU08028 on heroin relapse and choice in a rat model of opioid maintenance. Br J Pharmacol 2021; 179:227-241. [PMID: 34505281 DOI: 10.1111/bph.15679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Maintenance treatment with opioid agonists (buprenorphine, methadone) decreases opioid use and relapse. We recently modelled maintenance treatment in rats and found that chronic delivery of buprenorphine or the μ opioid receptor partial agonist TRV130 decreased relapse to oxycodone seeking and taking. Here, we tested the buprenorphine analogue BU08028 on different heroin relapse-related measures and heroin versus food choice. EXPERIMENTAL APPROACH For relapse assessment, we trained male and female rats to self-administer heroin (6 h·day-1 , 14 days) in Context A and then implanted osmotic minipumps containing BU08028 (0, 0.03 or 0.1 mg·kg-1 ·d-1 ). Effects of chronic BU08028 delivery were tested on (1) incubation of heroin-seeking in a non-drug Context B, (2) extinction responding reinforced by heroin-associated discrete cues in Context B, (3) reinstatement of heroin-seeking induced by re-exposure to Context A and (4) re-acquisition of heroin self-administration in Context A. For choice assessment, we tested the effect of chronic BU08028 delivery on heroin versus food choice. KEY RESULTS Chronic BU08028 delivery decreased incubation of heroin seeking. Unexpectedly, BU08028 increased re-acquisition of heroin self-administration selectively in females. Chronic BU08028 had minimal effects on context-induced reinstatement and heroin versus food choice in both sexes. Finally, exploratory post hoc analyses suggest that BU08028 decreased extinction responding selectively in males. CONCLUSIONS AND IMPLICATIONS Chronic BU08028 delivery had both beneficial and detrimental, sex-dependent, effects on different triggers of heroin relapse and minimal effects on heroin choice in both sexes. Results suggest that BU08028 would not be an effective opioid maintenance treatment in humans.
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Affiliation(s)
| | - E Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Ida Fredriksson
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, Maryland, USA
| | - Aniruddha Shekara
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, Maryland, USA
| | - Stephen Husbands
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Agnieszka Sulima
- Molecular Targets and Medications Discovery Branch, IRP/NIDA/NIH, Baltimore, Maryland, USA.,Chemical Biology Research Branch, IRP/NIAAA/NIH, Rockville, Maryland, USA
| | - Kenner C Rice
- Molecular Targets and Medications Discovery Branch, IRP/NIDA/NIH, Baltimore, Maryland, USA.,Chemical Biology Research Branch, IRP/NIAAA/NIH, Rockville, Maryland, USA
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Yavin Shaham
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, Maryland, USA
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11
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Addiction as a brain disease revised: why it still matters, and the need for consilience. Neuropsychopharmacology 2021; 46:1715-1723. [PMID: 33619327 PMCID: PMC8357831 DOI: 10.1038/s41386-020-00950-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. These criticisms state that the brain disease view is deterministic, fails to account for heterogeneity in remission and recovery, places too much emphasis on a compulsive dimension of addiction, and that a specific neural signature of addiction has not been identified. We acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. We also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic. Here, we therefore address these criticisms, and in doing so provide a contemporary update of the brain disease view of addiction. We provide arguments to support this view, discuss why apparently spontaneous remission does not negate it, and how seemingly compulsive behaviors can co-exist with the sensitivity to alternative reinforcement in addiction. Most importantly, we argue that the brain is the biological substrate from which both addiction and the capacity for behavior change arise, arguing for an intensified neuroscientific study of recovery. More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.
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12
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Lack of effect of different pain-related manipulations on opioid self-administration, reinstatement of opioid seeking, and opioid choice in rats. Psychopharmacology (Berl) 2021; 238:1885-1897. [PMID: 33765177 PMCID: PMC10041878 DOI: 10.1007/s00213-021-05816-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 01/26/2023]
Abstract
RATIONALE AND OBJECTIVE Pain-related factors increase the risk for opioid addiction, and pain may function as a negative reinforcer to increase opioid taking and seeking. However, experimental pain-related manipulations generally do not increase opioid self-administration in rodents. This discrepancy may reflect insufficient learning of pain-relief contingencies or confounding effects of pain-related behavioral impairments. Here, we determined if pairing noxious stimuli with opioid self-administration would promote pain-related reinstatement of opioid seeking or increase opioid choice over food. METHODS In Experiment 1, rats self-administered fentanyl in the presence or absence of repeated intraplantar capsaicin injections in distinct contexts to model context-specific exposure to cutaneous nociception. After capsaicin-free extinction in both contexts, we tested if capsaicin would reinstate fentanyl seeking. In Experiment 2, rats self-administered heroin after intraperitoneal (i.p.) lactic acid injections to model acute visceral inflammatory pain. After lactic acid-free extinction, we tested if lactic acid would reinstate heroin seeking. In Experiment 3, we tested if repeated i.p. lactic acid or intraplantar Complete Freund's Adjuvant (CFA; to model sustained inflammatory pain) would increase fentanyl choice over food. RESULTS In Experiments 1-2, neither capsaicin nor lactic acid reinstated opioid seeking after extinction, and lactic acid did not increase heroin-induced reinstatement. In Experiment 3, lactic acid and CFA decreased reinforcement rate without affecting fentanyl choice. CONCLUSIONS Results extend the range of conditions across which pain-related manipulations fail to increase opioid seeking in rats and suggest that enhanced opioid-addiction risk in humans with chronic pain involves factors other than enhanced opioid reinforcement and relapse.
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13
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Townsend EA, Schwienteck KL, Robinson HL, Lawson ST, Banks ML. A drug-vs-food "choice" self-administration procedure in rats to investigate pharmacological and environmental mechanisms of substance use disorders. J Neurosci Methods 2021; 354:109110. [PMID: 33705855 DOI: 10.1016/j.jneumeth.2021.109110] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Preclinical drug self-administration procedures are commonly used to investigate expression, mechanisms, and treatment of substance use disorders. NEW METHOD The aims were to back-translate an intravenous drug-vs-food choice procedure primarily utilized in monkeys to male and female rats and to develop a surgical method for sustained intravenous catheter patency suitable for long-term drug-choice studies. RESULTS The surgical protocol resulted in a median intravenous jugular catheter patency in male and female rats of 126 days (range: 25-365 days). Drug-vs-food choice was established with opioids (fentanyl and heroin), psychostimulants (cocaine, methamphetamine, and amphetamine), and an opioid/psychostimulant mixture (fentanyl + methamphetamine). The average time from catheter implantation to stable choice behavior across all drugs was 27 sessions (range: 16-44 sessions). Choice behavior stabilized more quickly for cocaine and fentanyl than for other drugs. Manipulations of both environmental variables (e.g., response requirement or food reinforcer magnitude) and pharmacological variables (e.g., extended access drug self-administration or continuous buprenorphine treatment via osmotic pump) significantly shifted opioid-vs-food choice consistent with previous monkey studies. COMPARISON WITH EXISTING METHODS Duration of intravenous catheter patency in rats was suitable for long-term, within-subject drug choice studies. Effects of environmental and pharmacological manipulations in rats confirmed and extended previous results from monkeys. CONCLUSIONS The concordance of behavioral results between rats and monkeys using the present drug-vs-food choice procedure supports its utility to improve our basic understanding of the expression and mechanisms of substance use disorders towards to development of more effective therapeutics.
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Affiliation(s)
- E Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
| | - Kathryn L Schwienteck
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Hannah L Robinson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Stephen T Lawson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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14
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Burgess-Hull A, Epstein DH. Ambulatory Assessment Methods to Examine Momentary State-Based Predictors of Opioid Use Behaviors. CURRENT ADDICTION REPORTS 2021; 8:122-135. [PMID: 33425652 PMCID: PMC7778403 DOI: 10.1007/s40429-020-00351-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW Addiction scientists have begun using ambulatory assessment methods-including ecological momentary assessment (EMA), experience sampling, and daily diaries-to collect real-time or near-real-time reports of participants' internal states in their natural environments. The goal of this short review is to synthesize EMA findings from our research group, which has studied several hundred outpatients during treatment for opioid-use disorder (OUD). (We cite pertinent findings from other groups, but have not tried to be comprehensive.) One of our main goals in using EMA is to examine momentary changes in internal states that proximally predict, or concurrently mark, events such as lapses to opioid use. RECENT FINDINGS We summarize findings evaluating several classes of momentary markers or predictors (craving, stress, negative and positive moods, and physical pain/discomfort) of lapses and other states/behaviors. Craving and some negatively valenced mood states are concurrently and prospectively associated with lapses to opioid use during treatment. Craving is also concurrently and prospectively associated with momentary changes in stress and mood. Convincing evidence has not yet emerged for stress as a robust redictor of lapse to opioid use; it appears to be contributory, but neither necessary nor sufficient. SUMMARY Ambulatory assessment can capture changes in internal states and drug-related behaviors in situ and at high temporal resolution. We recommend research strategies that may increase the clinical and prognostic utility of ambulatory assessment, including denser sampling (i.e., more assessments per day) and more attention to heterogeneity across people and across populations.
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Affiliation(s)
- Albert Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD USA
| | - David H. Epstein
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD USA
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15
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Panlilio LV, Stull SW, Bertz JW, Burgess-Hull AJ, Kowalczyk WJ, Phillips KA, Epstein DH, Preston KL. Beyond abstinence and relapse: cluster analysis of drug-use patterns during treatment as an outcome measure for clinical trials. Psychopharmacology (Berl) 2020; 237:3369-3381. [PMID: 32990768 PMCID: PMC7579498 DOI: 10.1007/s00213-020-05618-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/21/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Many people being treated for opioid use disorder continue to use drugs during treatment. This use occurs in patterns that rarely conform to well-defined cycles of abstinence and relapse. Systematic identification and evaluation of these patterns could enhance analysis of clinical trials and provide insight into drug use. OBJECTIVES To evaluate such an approach, we analyzed patterns of opioid and cocaine use from three randomized clinical trials of contingency management in methadone-treated participants. METHODS Sequences of drug test results were analyzed with unsupervised machine-learning techniques, including hierarchical clustering of categorical results (i.e., whether any samples were positive during each week) and K-means longitudinal clustering of quantitative results (i.e., the proportion positive each week). The sensitivity of cluster membership as an experimental outcome was assessed based on the effects of contingency management. External validation of clusters was based on drug craving and other symptoms of substance use disorder. RESULTS In each clinical trial, we identified four clusters of use patterns, which can be described as opioid use, cocaine use, dual use (opioid and cocaine), and partial/complete abstinence. Different clustering techniques produced substantially similar classifications of individual participants, with strong above-chance agreement. Contingency management increased membership in clusters with lower levels of drug use and fewer symptoms of substance use disorder. CONCLUSIONS Cluster analysis provides person-level output that is more interpretable and actionable than traditional outcome measures, providing a concrete answer to the question of what clinicians can tell patients about the success rates of new treatments.
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Affiliation(s)
- Leigh V Panlilio
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.
| | - Samuel W Stull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Jeremiah W Bertz
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Albert J Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - William J Kowalczyk
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
- Department of Psychology, Hartwick College, Oneonta, NY, 13820, USA
| | - Karran A Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Kenzie L Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
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16
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Improving translation of animal models of addiction and relapse by reverse translation. Nat Rev Neurosci 2020; 21:625-643. [PMID: 33024318 DOI: 10.1038/s41583-020-0378-z] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 12/13/2022]
Abstract
Critical features of human addiction are increasingly being incorporated into complementary animal models, including escalation of drug intake, punished drug seeking and taking, intermittent drug access, choice between drug and non-drug rewards, and assessment of individual differences based on criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Combined with new technologies, these models advanced our understanding of brain mechanisms of drug self-administration and relapse, but these mechanistic gains have not led to improvements in addiction treatment. This problem is not unique to addiction neuroscience, but it is an increasing source of disappointment and calls to regroup. Here we first summarize behavioural and neurobiological results from the animal models mentioned above. We then propose a reverse translational approach, whose goal is to develop models that mimic successful treatments: opioid agonist maintenance, contingency management and the community-reinforcement approach. These reverse-translated 'treatments' may provide an ecologically relevant platform from which to discover new circuits, test new medications and improve translation.
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17
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Dumitrascuta M, Bermudez M, Ballet S, Wolber G, Spetea M. Mechanistic Understanding of Peptide Analogues, DALDA, [Dmt 1]DALDA, and KGOP01, Binding to the mu Opioid Receptor. Molecules 2020; 25:E2087. [PMID: 32365707 PMCID: PMC7248707 DOI: 10.3390/molecules25092087] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 01/14/2023] Open
Abstract
The mu opioid receptor (MOR) is the primary target for analgesia of endogenous opioid peptides, alkaloids, synthetic small molecules with diverse scaffolds, and peptidomimetics. Peptide-based opioids are viewed as potential analgesics with reduced side effects and have received constant scientific interest over the years. This study focuses on three potent peptide and peptidomimetic MOR agonists, DALDA, [Dmt1]DALDA, and KGOP01, and the prototypical peptide MOR agonist DAMGO. We present the first molecular modeling study and structure-activity relationships aided by in vitro assays and molecular docking of the opioid peptide analogues, in order to gain insight into their mode of binding to the MOR. In vitro binding and functional assays revealed the same rank order with KGOP01 > [Dmt1]DALDA > DAMGO > DALDA for both binding and MOR activation. Using molecular docking at the MOR and three-dimensional interaction pattern analysis, we have rationalized the experimental outcomes and highlighted key amino acid residues responsible for agonist binding to the MOR. The Dmt (2',6'-dimethyl-L-Tyr) moiety of [Dmt1]DALDA and KGOP01 was found to represent the driving force for their high potency and agonist activity at the MOR. These findings contribute to a deeper understanding of MOR function and flexible peptide ligand-MOR interactions, that are of significant relevance for the future design of opioid peptide-based analgesics.
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Affiliation(s)
- Maria Dumitrascuta
- Department of Pharmaceutical Chemistry, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82, 6020 Innsbruck, Austria;
| | - Marcel Bermudez
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Str. 2+4, D-14195 Berlin, Germany;
| | - Steven Ballet
- Research Group of Organic Chemistry, Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium;
| | - Gerhard Wolber
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Str. 2+4, D-14195 Berlin, Germany;
| | - Mariana Spetea
- Department of Pharmaceutical Chemistry, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82, 6020 Innsbruck, Austria;
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18
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Fredriksson I, Applebey SV, Minier-Toribio A, Shekara A, Bossert JM, Shaham Y. Effect of the dopamine stabilizer (-)-OSU6162 on potentiated incubation of opioid craving after electric barrier-induced voluntary abstinence. Neuropsychopharmacology 2020; 45:770-779. [PMID: 31905372 PMCID: PMC7075949 DOI: 10.1038/s41386-020-0602-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/17/2019] [Indexed: 01/08/2023]
Abstract
In the classical incubation of drug craving rat model, drug seeking is assessed after homecage forced abstinence. However, human abstinence is often voluntary because negative consequences of drug seeking outweigh the desire for the drug. Here, we developed a rat model of incubation of opioid craving after electric barrier-induced voluntary abstinence and determined whether the dopamine stabilizer (-)-OSU6162 would decrease this new form of incubation. We trained male and female rats to self-administer oxycodone (0.1 mg/kg/infusion, 6 h/day) for 14 days. We then exposed them to either homecage forced abstinence or voluntary abstinence induced by an electric barrier of increasing intensity near the drug-paired lever. On abstinence days 1, 15, or 30, we tested the rats for oxycodone seeking without shock and drug. We also examined the effect of (-)-OSU6162 (7.5 and 15 mg/kg) on oxycodone seeking on abstinence day 1 or after 15 days of either voluntary or forced abstinence. Independent of sex, the time-dependent increase in oxycodone seeking after cessation of opioid self-administration (incubation of opioid craving) was stronger after voluntary abstinence than after forced abstinence. In males, (-)-OSU6162 decreased incubated (day 15) but not non-incubated (day 1) oxycodone seeking after either voluntary or forced abstinence. In females, (-)-OSU6162 modestly decreased incubated oxycodone seeking after voluntary but not forced abstinence. Results suggest that voluntary abstinence induced by negative consequences of drug seeking can paradoxically potentiate opioid craving and relapse. We propose the dopamine stabilizer (-)-OSU6162 may serve as an adjunct pharmacological treatment to prevent relapse in male opioid users.
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Affiliation(s)
- Ida Fredriksson
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, USA.
| | | | | | | | | | - Yavin Shaham
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, USA.
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19
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Epstein DH, Tyburski M, Kowalczyk WJ, Burgess-Hull AJ, Phillips KA, Curtis BL, Preston KL. Prediction of stress and drug craving ninety minutes in the future with passively collected GPS data. NPJ Digit Med 2020; 3:26. [PMID: 32195362 PMCID: PMC7055250 DOI: 10.1038/s41746-020-0234-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/06/2020] [Indexed: 12/16/2022] Open
Abstract
Just-in-time adaptive interventions (JITAIs), typically smartphone apps, learn to deliver therapeutic content when users need it. The challenge is to "push" content at algorithmically chosen moments without making users trigger it with effortful input. We trained a randomForest algorithm to predict heroin craving, cocaine craving, or stress (reported via smartphone app 3x/day) 90 min into the future, using 16 weeks of field data from 189 outpatients being treated for opioid-use disorder. We used only one form of continuous input (along with person-level demographic data), collected passively: an indicator of environmental exposures along the past 5 h of movement, as assessed by GPS. Our models achieved excellent overall accuracy-as high as 0.93 by the end of 16 weeks of tailoring-but this was driven mostly by correct predictions of absence. For predictions of presence, "believability" (positive predictive value, PPV) usually peaked in the high 0.70s toward the end of the 16 weeks. When the prediction target was more rare, PPV was lower. Our findings complement those of other investigators who use machine learning with more broadly based "digital phenotyping" inputs to predict or detect mental and behavioral events. When target events are comparatively subtle, like stress or drug craving, accurate detection or prediction probably needs effortful input from users, not passive monitoring alone. We discuss ways in which accuracy is difficult to achieve or even assess, and warn that high overall accuracy (including high specificity) can mask the abundance of false alarms that low PPV reveals.
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Affiliation(s)
- David H. Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - Matthew Tyburski
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - William J. Kowalczyk
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - Albert J. Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - Karran A. Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - Brenda L. Curtis
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
| | - Kenzie L. Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224 USA
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20
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Smith KE, Tillson MD, Staton M, Winston EM. Characterization of diverted buprenorphine use among adults entering corrections-based drug treatment in Kentucky. Drug Alcohol Depend 2020; 208:107837. [PMID: 31951906 PMCID: PMC7418075 DOI: 10.1016/j.drugalcdep.2020.107837] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/17/2019] [Accepted: 12/26/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Illicit, medically unsupervised use of buprenorphine (i.e., "diverted use") among vulnerable and underserved populations, such as corrections-involved adults, remains underexplored. METHODS Survey data (2016-2017) collected as part of a clinical assessment of incarcerated adults entering corrections-based substance use treatment in Kentucky were analyzed. For years examined, 12,915 completed the survey. Removing cases for participants who did not reside in Kentucky for >6 months during the one-year pre-incarceration period (n = 908) resulted in a final sample size of 12,007. RESULTS Over a quarter of the sample reported past-year diverted buprenorphine use prior to incarceration and 21.8 % reported use during the 30-days prior to incarceration, using 6.5 months and 14.3 days on average, respectively. A greater proportion of participants who reported diverted buprenorphine use had previously been engaged with some substance use treatment (77.0 %) and reported greater perceived need for treatment (79.4 %) compared to those who did not report use. Use was more likely among participants who were younger, white, male, and who reported rural or Appalachian residence. Diverted buprenorphine users also evidenced extensive polydrug use and presented with greater substance use disorder severity. Non-medical prescription opioid, heroin, and diverted methadone use were associated with increased odds of diverted buprenorphine use while kratom was not. Diverted methadone use was associated with a 252.9 % increased likelihood of diverted buprenorphine use. CONCLUSIONS Diverted buprenorphine use among participants in this sample was associated with concerning high-risk behaviors and may indicate barriers to accessing opioid agonist therapies for corrections-involved Kentucky residents, particularly those in rural Appalachia.
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Affiliation(s)
- Kirsten E Smith
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, Kentucky 40508, United States; Kent School of Social Work, University of Louisville, Louisville, Kentucky, 40292, United States.
| | - Martha D Tillson
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, Kentucky 40508, United States; Department of Sociology, University of Kentucky, Lexington, Kentucky, 40508, United States
| | - Michele Staton
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, Kentucky 40508, United States; Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, 40508, United States
| | - Erin M Winston
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, Kentucky 40508, United States
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21
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Venniro M, Russell TI, Zhang M, Shaham Y. Operant Social Reward Decreases Incubation of Heroin Craving in Male and Female Rats. Biol Psychiatry 2019; 86:848-856. [PMID: 31326085 PMCID: PMC8383184 DOI: 10.1016/j.biopsych.2019.05.018] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/20/2019] [Accepted: 05/20/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND We recently reported that operant social choice-induced voluntary abstinence prevents incubation of methamphetamine craving. Here, we determined whether social choice-induced voluntary abstinence would prevent incubation of heroin craving. We also introduce a fully automatic social reward self-administration model that eliminates the intense workload and rat-human interaction of the original semiautomatic model. METHODS In experiment 1, we trained male and female rats for social self-administration (6 days) and then for heroin self-administration (12 days). Next, we assessed relapse to heroin seeking after 1 and 15 abstinence days. Between tests, the rats underwent either forced or social choice-induced abstinence. In experiment 2, we developed a fully automatic social self-administration procedure by introducing a screen between the self-administration chamber and the social-peer chamber; the screen allows physical contact but prevents rats from crossing chambers. Next, we compared incubation of craving in rats with a history of standard (no-screen) or automatic (screen) social self-administration and social choice-induced abstinence. RESULTS The time-dependent increase in heroin seeking after cessation of drug self-administration (incubation of craving) was lower after social choice-induced abstinence than after forced abstinence. There were no differences in social self-administration, social choice-induced abstinence, and incubation of craving in rats trained in the standard semiautomatic procedure versus the novel fully automatic procedure. CONCLUSIONS Our study demonstrates the protective effect of rewarding social interaction on heroin self-administration and incubation of heroin craving and introduces a fully automatic social self-administration and choice procedure to investigate the role of volitional social interaction in drug addiction and other psychiatric disorders.
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Affiliation(s)
- Marco Venniro
- Behavioral Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland.
| | - Trinity I Russell
- Behavioral Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Michelle Zhang
- Behavioral Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Yavin Shaham
- Behavioral Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
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Claff T, Yu J, Blais V, Patel N, Martin C, Wu L, Han GW, Holleran BJ, Van der Poorten O, White KL, Hanson MA, Sarret P, Gendron L, Cherezov V, Katritch V, Ballet S, Liu ZJ, Müller CE, Stevens RC. Elucidating the active δ-opioid receptor crystal structure with peptide and small-molecule agonists. SCIENCE ADVANCES 2019; 5:eaax9115. [PMID: 31807708 PMCID: PMC6881160 DOI: 10.1126/sciadv.aax9115] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/25/2019] [Indexed: 05/13/2023]
Abstract
Selective activation of the δ-opioid receptor (DOP) has great potential for the treatment of chronic pain, benefitting from ancillary anxiolytic and antidepressant-like effects. Moreover, DOP agonists show reduced adverse effects as compared to μ-opioid receptor (MOP) agonists that are in the spotlight of the current "opioid crisis." Here, we report the first crystal structures of the DOP in an activated state, in complex with two relevant and structurally diverse agonists: the potent opioid agonist peptide KGCHM07 and the small-molecule agonist DPI-287 at 2.8 and 3.3 Å resolution, respectively. Our study identifies key determinants for agonist recognition, receptor activation, and DOP selectivity, revealing crucial differences between both agonist scaffolds. Our findings provide the first investigation into atomic-scale agonist binding at the DOP, supported by site-directed mutagenesis and pharmacological characterization. These structures will underpin the future structure-based development of DOP agonists for an improved pain treatment with fewer adverse effects.
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Affiliation(s)
- Tobias Claff
- iHuman Institute, ShanghaiTech University, Ren Building, 393 Middle Huaxia Rd, Pudong, Shanghai 201210, China
- PharmaCenter Bonn, University of Bonn, Pharmaceutical Chemistry I, An der Immenburg 4, D-53121 Bonn, Germany
| | - Jing Yu
- iHuman Institute, ShanghaiTech University, Ren Building, 393 Middle Huaxia Rd, Pudong, Shanghai 201210, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
- CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai 200031, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Véronique Blais
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Nilkanth Patel
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
| | - Charlotte Martin
- Research Group of Organic Chemistry, Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Lijie Wu
- iHuman Institute, ShanghaiTech University, Ren Building, 393 Middle Huaxia Rd, Pudong, Shanghai 201210, China
| | - Gye Won Han
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
| | - Brian J. Holleran
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Olivier Van der Poorten
- Research Group of Organic Chemistry, Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Kate L. White
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
| | | | - Philippe Sarret
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Louis Gendron
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Institut de Pharmacologie de Sherbrooke, Centre de Recherche du CHUS, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Vadim Cherezov
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
| | - Vsevolod Katritch
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
| | - Steven Ballet
- Research Group of Organic Chemistry, Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Zhi-Jie Liu
- iHuman Institute, ShanghaiTech University, Ren Building, 393 Middle Huaxia Rd, Pudong, Shanghai 201210, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Christa E. Müller
- PharmaCenter Bonn, University of Bonn, Pharmaceutical Chemistry I, An der Immenburg 4, D-53121 Bonn, Germany
- Corresponding author. (C.E.M.); (R.C.S.)
| | - Raymond C. Stevens
- iHuman Institute, ShanghaiTech University, Ren Building, 393 Middle Huaxia Rd, Pudong, Shanghai 201210, China
- Departments of Biological Sciences and Chemistry, Bridge Institute, USC Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA 90089, USA
- Corresponding author. (C.E.M.); (R.C.S.)
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24
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Brennan MJ, Gudin JA. The prescription opioid conundrum: 21st century solutions to a millennia-long problem. Postgrad Med 2019; 132:17-27. [PMID: 31591925 DOI: 10.1080/00325481.2019.1677383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Health-care professionals are faced with a daunting task: balancing appropriate care for chronic pain with their responsibility to keep patients and others safe from treatment-related harm. Whereas opioids have historically been considered an effective tool in the analgesic armamentarium, the rise of opioid abuse has caused the pendulum to swing away from prescribing opioids to an emphasis on safety. This paradigm shift risks neglecting the very real consequences of untreated/undertreated pain. Using data from the medical literature, this review examines influences on the real and perceived benefit-to-risk ratio for opioids and provides clinicians with a practical approach to prescribing opioids that minimizes the risk for abuse/misuse. There is appreciable clinical trial and observational evidence of efficacy/effectiveness with opioids used for pain management over the short or long term when considered in the context of pharmacologic alternatives. Enhancing the relative safety and minimizing the risk for abuse/misuse may be achieved through proactive prescription practices that include careful patient selection, risk assessment, individualized and multimodal treatment plans with established goals, initiating opioid treatment cautiously with an exit plan in place, ongoing assessments of response to therapy, and routine patient monitoring. Additionally, prescribing opioids with a lower potential for abuse or misuse (e.g. abuse-deterrent formulations) may provide a benefit. Using a pragmatic approach to prescribing practices, we postulate that the balance between benefit and risk can be favorable for opioid therapy in select patients, even for long-term treatment of chronic pain.
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Affiliation(s)
| | - Jeffrey A Gudin
- Pain Management and Palliative Care, Englewood Hospital and Medical Center, Englewood, NJ, USA
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25
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Townsend EA, Blake S, Faunce KE, Hwang CS, Natori Y, Zhou B, Bremer PT, Janda KD, Banks ML. Conjugate vaccine produces long-lasting attenuation of fentanyl vs. food choice and blocks expression of opioid withdrawal-induced increases in fentanyl choice in rats. Neuropsychopharmacology 2019; 44:1681-1689. [PMID: 31043682 PMCID: PMC6784909 DOI: 10.1038/s41386-019-0385-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/19/2019] [Accepted: 04/01/2019] [Indexed: 12/31/2022]
Abstract
The current opioid crisis remains a significant public health issue and there is a critical need for biomedical research to develop effective and easily deployable candidate treatments. One emerging treatment strategy for opioid use disorder includes immunopharmacotherapies or opioid-targeted vaccines. The present study determined the effectiveness of a fentanyl-tetanus toxoid conjugate vaccine to alter fentanyl self-administration using a fentanyl-vs.-food choice procedure in male and female rats under three experimental conditions. For comparison, continuous 7-day naltrexone (0.01-0.1 mg/kg/h) and 7-day clonidine (3.2-10 μg/kg/h) treatment effects were also determined on fentanyl-vs.-food choice. Male and female rats responded for concurrently available 18% diluted Ensure® (liquid food) and fentanyl (0-10 μg/kg/infusion) infusions during daily sessions. Under baseline and saline treatment conditions, fentanyl maintained a dose-dependent increase in fentanyl-vs.-food choice. First, fentanyl vaccine administration significantly blunted fentanyl reinforcement and increased food reinforcement for 15 weeks in non-opioid dependent rats. Second, surmountability experiments by increasing the unit fentanyl dose available during the self-administration session 10-fold empirically determined that the fentanyl vaccine produced an approximate 22-fold potency shift in fentanyl-vs.-food choice that was as effective as the clinically approved treatment naltrexone. Clonidine treatment significantly increased fentanyl-vs.-food choice. Lastly, fentanyl vaccine administration prevented the expression of withdrawal-associated increases in fentanyl-vs.-food choice following introduction of extended 12 h fentanyl access sessions. Overall, these results support the potential and further consideration of immunopharmacotherapies as candidate treatments to address the current opioid crisis.
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Affiliation(s)
- E Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Steven Blake
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Kaycee E Faunce
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Candy S Hwang
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Department of Chemistry, Southern Connecticut State University, 501 Crescent St, New Haven, CT, 06515, USA
| | - Yoshihiro Natori
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Komatsushima 4-4-1, Aoba-ku, Sendai, 981-8558, Japan
| | - Bin Zhou
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Paul T Bremer
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Kim D Janda
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA.
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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Panlilio LV, Stull SW, Kowalczyk WJ, Phillips KA, Schroeder JR, Bertz JW, Vahabzadeh M, Lin JL, Mezghanni M, Nunes EV, Epstein DH, Preston KL. Stress, craving and mood as predictors of early dropout from opioid agonist therapy. Drug Alcohol Depend 2019; 202:200-208. [PMID: 31357121 PMCID: PMC6707374 DOI: 10.1016/j.drugalcdep.2019.05.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/09/2019] [Accepted: 05/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Treatment with opioid agonists is effective for opioid use disorder, but early discontinuation of treatment is a major obstacle to success. Intensive longitudinal methods - which take many repeated measurements over time, usually in the field- have provided unique insight into the effects of stress, mood and craving on drug use while people are being treated; these methods might also be useful for studying the processes that lead people to drop out of treatment. METHODS Ecological momentary assessment (EMA) was conducted for up to 17 weeks by obtaining multiple electronic diary entries per day from 238 participants being treated with methadone or buprenorphine-naloxone. Survival analysis was used to study two outcomes: dropping out of treatment and noncompliance with EMA self-report requirements. Self-reports of stress, craving, and mood were used as time-varying predictors. Demographic and psychosocial variables measured with the Addiction Severity Index at the start of treatment were used as time-invariant predictors. RESULTS Dropping out of treatment was more likely in participants with more reported hassles (a measure of stress), higher levels of cocaine craving, lower levels of positive mood, a recent history of emotional abuse, a recent history of being bothered frequently by psychological problems, and with buprenorphine rather than methadone as their medication. In contrast, study noncompliance was not significantly associated with any of the variables analyzed. CONCLUSIONS Assessment of stress, craving and mood during treatment might identify people who are at greater risk of dropping out, and therapeutic interventions targeting these processes might increase retention.
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Affiliation(s)
- Leigh V Panlilio
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Samuel W Stull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - William J Kowalczyk
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Karran A Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | | | - Jeremiah W Bertz
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Massoud Vahabzadeh
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Jia-Ling Lin
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Mustapha Mezghanni
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Edward V Nunes
- Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York, NY, 10032, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Kenzie L Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.
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Smith KE, Bunting AM, Walker R, Hall MT, Grundmann O, Castillo O. Non-Prescribed Buprenorphine Use Mediates the Relationship between Heroin Use and Kratom Use among a Sample of Polysubstance Users. J Psychoactive Drugs 2019; 51:311-322. [PMID: 30961450 PMCID: PMC10083077 DOI: 10.1080/02791072.2019.1597224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In Asia, Mitragyna speciosa (e.g., "kratom") has been used to mitigate alcohol and drug dependence. Some preliminary findings suggest kratom's potential use as an informal harm-reduction method in the United States, such as an opioid substitute or as a means of lessening opioid withdrawal symptoms. To determine correlates of past-year kratom use among a sample of polysubstance users enrolled in residential recovery programs in Kentucky, an anonymous survey was completed by clients in April 2017. Logistic regression was used to identify significant associations with past-year kratom use. Of the final sample (N = 478), 10.4% reported past-year kratom use. Past-year heroin use, but not past-year prescription opioid (e.g., oxycodone, hydrocodone) use, was significantly associated with kratom use, such that individuals who reported past-year heroin use were 2.5 times more likely to also report past-year kratom use. Non-prescribed buprenorphine (i.e., Suboxone) use partially mediated the relationship between past-year heroin and kratom use by explaining 36% of the association between the two drugs. Though amphetamines were highly preferred, past-year use was negatively correlated with past-year kratom use. Rates of past-year kratom use were lower than rates of alcohol and illicit drug use. Kratom was not preferred over heroin or prescription opioids.
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Affiliation(s)
- Kirsten E. Smith
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | | | - Robert Walker
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Martin T. Hall
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Oliver Grundmann
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Olivia Castillo
- University of Miami School of Law, University of Miami, Coral Gables, FL, USA
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Reiner DJ, Fredriksson I, Lofaro OM, Bossert JM, Shaham Y. Relapse to opioid seeking in rat models: behavior, pharmacology and circuits. Neuropsychopharmacology 2019; 44:465-477. [PMID: 30293087 PMCID: PMC6333846 DOI: 10.1038/s41386-018-0234-2] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/17/2018] [Accepted: 09/27/2018] [Indexed: 12/13/2022]
Abstract
Lifetime relapse rates remain a major obstacle in addressing the current opioid crisis. Relapse to opioid use can be modeled in rodent studies where drug self-administration is followed by a period of abstinence and a subsequent test for drug seeking. Abstinence can be achieved through extinction training, forced abstinence, or voluntary abstinence. Voluntary abstinence can be accomplished by introducing adverse consequences of continued drug self-administration (e.g., punishment or electric barrier) or by introducing an alternative nondrug reward in a discrete choice procedure (drug versus palatable food or social interaction). In this review, we first discuss pharmacological and circuit mechanisms of opioid seeking, as assessed in the classical extinction-reinstatement model, where reinstatement is induced by reexposure to the self-administered drug (drug priming), discrete cues, discriminative cues, drug-associated contexts, different forms of stress, or withdrawal states. Next, we discuss pharmacological and circuit mechanisms of relapse after forced or voluntary abstinence, including the phenomenon of "incubation of heroin craving" (the time-dependent increases in heroin seeking during abstinence). We conclude by discussing future directions of preclinical relapse-related studies using opioid drugs.
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Affiliation(s)
- David J. Reiner
- Behavioral Neuroscience Research Branch, IRP-NIDA-NIH, Baltimore, MD USA
| | - Ida Fredriksson
- Behavioral Neuroscience Research Branch, IRP-NIDA-NIH, Baltimore, MD USA
| | - Olivia M. Lofaro
- Behavioral Neuroscience Research Branch, IRP-NIDA-NIH, Baltimore, MD USA
| | | | - Yavin Shaham
- Behavioral Neuroscience Research Branch, IRP-NIDA-NIH, Baltimore, MD, USA.
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