Naloxone Antagonism as Evidence for Narcotic Mechanisms

A perceptual-defensive-recuperative model of fear and pain

A model of fear and pain is presented in which the two are assumed to activate totally different classes of behavior. Fear, produced by stimuli that are associated with painful events, results in defensive behavior and the inhibition of pain and pain-related behaviors. On the other hand, pain, produced by injurious stimulation, motivates recuperative behaviors that promote healing. In this model injurious stimulation, on the one hand, and the expectation of injurious stimulation, on the other hand, activate entirely different motivational systems which serve entirely different functions. The fear motivation system activates defensive behavior, such as freezing and flight from a frightening situation, and its function is to defend the animal against natural dangers, such as predation. A further effect of fear motivation is to organize the perception of environmental events so as to facilitate the perception of danger and safety. The pain motivation system activates recuperative behaviors, including resting and body-care responses, and its function is to promote the animal's recovery from injury. Pain motivation also selectively facilitates the perception of nociceptive stimulation. Since the two kinds of motivation serve different and competitive functions, it might be expected that they would interact through some kind of mutual inhibition. Recent research is described which indicates that this is the case. The most important connection is the inhibition of pain by fear; fear has the top priority. This inhibition appears to be mediated by an endogenous analgesic mechanism involving the endorphins. The model assumes that fear triggers the endorphin mechanism, thereby inhibiting pain motivation and recuperative behaviors that might compete with effective defensive behavior.

Peripheral but not intracerebroventricular corticotropin-releasing hormone (CRH) produces antinociception which is not opioid mediated

Corticotropin-releasing hormone and endogenous opioid peptide systems are both activated during stress. An elevation of the pain threshold also occurs under conditions of stress. In the present study the effects of CRH antinociception were examined. Rats were treated with CRH either centrally (i.c.v.) or peripherally (intracardially; i.c.) and their tail-flick latencies were measured. Central application of CRH (0-30 micrograms) was without effect on the analgesic test, while after peripheral application (0-32 micrograms) CRH produced a dose-dependent increase in tail-flick latencies. In a subsequent experiment we examined the possible involvement of endogenous opioids in the peripheral CRH-induced antinociceptive effects. To this end, two approaches were used: animals were either acutely treated with the opioid antagonist naloxone (3 or 6 mg/kg), or they were rendered tolerant to morphine, and then tested with CRH. In both cases, CRH effects on the tail-flick latencies were not modified. Our findings suggest that: (a) CRH may modulate pain sensitivity during stress; (b) opioids do not mediate this effect; and (c) brain CRH receptors are probably not involved in these processes.

The effects of intraperitoneal administration of antagonists and development of morphine tolerance on the antinociception induced by stimulating the anterior pretectal nucleus of the rat

1 The effects of intraperitoneal administration of antagonists to morphine, 5-hydroxytryptamine (5-HT), noradrenaline and dopamine have been studied on the antinociceptive effects of electrical stimulation of the anterior pretectal nucleus (APtN) of the rat. 2 A 15 s period of 35 microA sine wave stimulation of APtN significantly increased the latency of the tail flick reflex to noxious heat for periods up to 1 h. 3 Naloxone (0.25-1.0 mg kg-1) attenuated the effects of APtN stimulation in a dose-dependent manner. In rats made tolerant to morphine by daily administration of morphine, the antinociceptive effects of APtN stimulation were significantly reduced. 4 The 5-HT receptor antagonists methysergide (5 mg kg-1) and ketanserin (1 mg kg-1), the dopamine receptor antagonist haloperidol (1 mg kg-1) and the beta-adrenoceptor antagonist propranolol (1 mg kg-1) had little effect on the antinociceptive effects of stimulating the APtN. 5 alpha-Adrenoceptor antagonists caused a dose-dependent antagonism of the response. The order of potency was; idazoxan greater than prazosin greater than phenoxybenzamine, the respective ED50 for each drug being 0.08: 0.45: 1.5 mg kg-1. 6 It is concluded that antagonism at opioid receptors and alpha-adrenoceptors but not beta-adrenoceptors, dopamine or 5-HT receptors reduces the antinociceptive effects of APtN stimulation. This differs from the reported effects of these antagonists on the antinociception caused by stimulating other sites in the brain.

Attempted antagonism of adenosine analogue induced depression of respiration

Intracerebroventricular (ICV) administration of the stable adenosine analogue 2-chloroadenosine (2CA) to hyperoxic halothane-anesthetized rats produced a dose-dependent depression of respiration largely as a result of a decrease in tidal volume. Similar changes were noted after another adenosine analogue, phenylisopropyladenosine (PIA). Higher doses shifted the minute ventilation-PaCO2 curve to the right and decreased its slope. Bradycardia and hypotension were produced at doses which altered respiration. Neonatal destruction of brain serotonin or dopamine-containing nerve terminals did not alter the 2CA-induced respiratory depression. Naloxone significantly antagonized the respiratory and circulatory changes produced by 2CA though the changes produced by PIA were not significantly antagonized. Peripherally and intracerebroventricularly administered theophylline were largely ineffective in reversing the 2CA-induced respiratory depression. Thus, these data suggest that a major part of the respiratory depression produced by 2CA is due to indirect activation of opioid receptors. In contrast, very little of the respiratory depression after PIA is via mechanisms antagonized by naloxone. Thus, putative adenosine agonists appear to vary in the extent to which respiratory depression is provoked by interactions with opioid systems.

Stress induced analgesia in frogs: a naloxone insensitive system

Repeated algesiometric testing of frogs with acetic acid can, under certain circumstances, lead to a pronounced elevation of their nociceptive threshold. Analgesia is reliably induced if algesiometric testing is begun shortly after the animals are placed in the testing cages, but not if the animals are allowed 3 days in which to recover from the stress of transfer and to acclimate to the test environment. Naloxone at doses up to 10 mg/kg neither blocks nor reverses this form of stress-induced analgesia. These data indicate that frogs, like some mammals, can use non-opiate mechanisms to modulate either their perception of or response to noxious stimuli.

Naloxone hyperalgesia and stress-induced analgesia in rats

Since past studies concerning the effects of naloxone on nociception have yielded inconclusive findings, the variables of pain test, baseline sensitivity, and stress condition were examined. Within a pure-bred strain of rats, consistent individual differences did not occur. All three measures of pain responsiveness demonstrated hyperalgesic effects of naloxone, but they differed in their capacity to reflect the effects of analgesia produced by continuous or intermittent electrical shock. By some measures, naloxone reversed the stress-induced analgesia due to intermittent shock; it did not influence the analgesia produced by continuous stress. The data support a model of pain inhibition involving both opioid and non-opioid systems and suggest that the hyperalgesic effects of naloxone can sometimes give rise to erroneous conclusions concerning apparent naloxone-reversability of putative analgesic procedures.

Effects of naloxone on systemic and cerebral responses to experimental concussive brain injury in cats

This study examined the effects of bolus injections of naloxone hydrochloride, a specific narcotic antagonist, on systemic cardiovascular function, intracranial and cerebral perfusion pressures, blood gas status, and cortical encephalograms (EEG's) in 38 cats after two different grades of experimental brain injury. Naloxone had no prolonged effects on uninjured control animals. However, as compared to a saline-injected control group, naloxone significantly reversed the hypotension and reduction in pulse pressure seen after higher grades of injury. These changes persisted for at least 60 minutes after injection and were accompanied by increased intracranial and perfusion pressures. More severely injured hypotensive cats injected with naloxone also had higher values of arterial pO2 and pH, lower pCO2, as well as higher EEG amplitudes. In less severely injured normotensive cats, naloxone produced greater effects on cardiovascular variables and intracranial pressure when injected 15 minutes rather than 45 minutes after injury. These data suggest that endogenous opiates may contribute to some instances of hypotension seen after concussive brain injury. Levels of endogenous opiates may also increase transiently even with lesser degrees of injury not associated with hypotension. The possible clinical application of narcotic antagonists to the treatment of head injury is discussed.

Naloxone fails to reverse pain thresholds elevated by acupuncture: acupuncture analgesia reconsidered

We were unable to demonstrate the reversal of dental acupunctural analgesia following the injection of 0.4 mg naloxone using evoked potential methodology. Since our findings differed from those of Mayer, Price and Rafii who used pain threshold methods, we attempted to replicate their study. Subjects who demonstrated acupunctural analgesia during electrical stimulation of the LI-4 point on the hands received either 1.2 mg naloxone or normal saline under double blind conditions. Pain thresholds elevated by acupuncture failed to reverse when naloxone was given. Review of experimental design issues, other related human subjects research, and animal studies on acupunctural analgesia provided little convincing evidence that endorphins play a significant role in acupunctural analgesia. Because endorphins can be released in response to a stressor, endorphin presence sometimes correlates with acupunctural treatment in animal studies and some human studies, especially those involving pain patients. The primary analgesia elicited by acupunctural stimulation seems to involve other mechanisms.

Addictive agents and intracranial stimulation (ICS): novel antagonists and agonists of morphine and pressing for ICS

Rats fixed with chronically indwelling bipolar electrodes pressed for intracranial stimulation (ICS) of the lateral hypothalamus during daily sessions. The effects of two antagonists of morphine (Win 44,441 and naloxone) were then assessed. Naloxone (10 mg/kg) produced its characteristic reduction in pressing. Win 44, 441 produced a reliable increase in pressing at doses as small as 1 mg/kg. Large doses of morphine (10 mg/kg) produced its characteristic effects: depression in pressing when given 1 hr before the test session and facilitation when given 3 hr before the test session. Win 44,441 antagonized morphine's depressive effects. Other compounds (Win 44,156, Win 42,156), having similar structure to Win 44,441 but having agonist and mixed agonist-antagonist activity with respect to analgesia, also facilitated pressing for ICS. All three compounds' effects on pressing for ICS were antagonized by naloxone. It is inferred that opioids' facilitatory effects on pressing for ICS are separable from opioids' other capabilities such as production of analgesia.

Does naloxone have functional significant activity on medial thalamic neurons? Microiontophoretical study

Local administration (microiontophoretically) of naloxone was tested in 57 parafascicularis thalamic (PF) neurons of morphine-naive and morphine-dependent rats. In morphine-naive rats microiontophoretic applications of naloxone induced changes in 52% of the PF neurons. Reduction in neuronal activity was observed in the majority of them; this reduction phenomena exhibited dose response characteristics, i.e., each incremental naloxone dose caused further decrease of the neuronal discharges. In morphine-dependent animals, 64% of the PF neurons were affected. The changes seen after naloxone were mainly increases of electrical discharges (i.e. the opposite effects obtained in morphine-naive animals).

Classical conditioning of front paw and hind paw footshock induced analgesia (FSIA): naloxone reversibility and descending pathways

Opiate and non-opiate footshock induced analgesia (FSIA) has recently been observed to be differentially elicited dependent upon the body region shocked; front paw and hind paw shock produce opiate and non-opiate analgesia, respectively. Previous studies have shown that footshock can also produce classically conditioned analgesia; that is, when shock is delivered to an animal, environmental cues become associated with the noxious stimulus such that these cues become capable, in and of themselves, of producing potent analgesia. The present series of experiments examined analgesia classically conditioned to either front paw or hind paw shock. The non-electrified shock grid served as the conditioned stimulus (CS), 90-s footshock as the unconditioned stimulus (UCS) and tail-flick inhibition as the unconditioned response (UCR). Following CS-UCS pairings, exposure to the non-electrified grid reliably produced prolonged analgesia. This classically conditioned analgesia appears to involve endogenous opioids, regardless of the body region shocked during conditioning trials, since the analgesia is attenuated by systemic naloxone and shows cross-tolerance to morphine. A spinal opioid site is involved since 1 microgram of naloxone delivered directly to the lumbosacral cord antagonizes the analgesia. Like front paw (opiate) FSIA, CCA can be prevented but cannot be reversed by naloxone; naloxone can antagonize classically conditioned analgesia only if it is delivered prior to exposure to the conditioned stimulus. Lastly, a similarity was recognized between classically conditioned analgesia and the analgesia induced by morphine, brain stimulation, front paw shock and hind paw shock in that all are mediated via descending pathways within the dorsolateral funiculus of the spinal cord.

Effects of systemic naloxone upon ventrobasal thalamus neuronal responses in arthritic rats

This study deals with the effect of various doses of systemic naloxone (10 microgram, 300 microgram, 1 mg/kg) upon activities of 21 ventrobasa thalamus neurons recorded in 20 rats rendered arthritic by injection of Freund's adjuvant into the tail. These neurons presented reproducible responses to movement and/or mild lateral pressure on a joint and were recorded for at least 30 min after naloxone administration. Several neurons (5) were tested with two doses. After intravenous injection of naloxone at the dose of 10 microgram/kg (10 cases) there was a rapid decrease of the responses. The maximum effect occurred at 15 min when the mean value expressed as a percentage of the control was 46.20 +/- 8.51% (n = 10, P less than 0.001). Recovery could be considered as complete at 30 min. At the dose of 300 microgram/kg (9 cases), the decrease in the responses was less important, variable from one neuron to another but significant between 5 and 20 min (mean = 67.43 +/- 9.00% at 20 min, n = 7, P less than 0.01). At the dose of 1 mg/kg (7 cases), there was no significant modification of the response. Spontaneous firing rate of the neurons was slightly but significantly increased after injection of the two highest doses and unmodified after the lowest. The relationship between the depressive effect produced by low doses of naloxone upon the neuronal responses, and the 'bi-directional' analgesic-hyperalgesic action of the drug, demonstrated in these suffering rats, is discussed.

Opiate vs non-opiate footshock-induced analgesia (FSIA): the body region shocked is a critical factor

Previous work has demonstrated that footshock can elicit either opiate or non-opiate analgesia. The present study has demonstrated that one critical factor determining the involvement of endogenous opioids is the body region shocked. Using 90 s shock, front paw shock produced an opiate analgesia which was significantly antagonized by as little as 0.1 mg/kg systemic naloxone and morphine tolerance. In the latter experiment, a parallel recovery of the analgesic potencies of both front paw shock and morphine was observed following 2 weeks of opiate abstinence. In contrast, hind paw shock produced a non-opiate analgesia which failed to be attenuated by 20 mg/kg systemic naloxone and showed no cross-tolerance to morphine. Since identical shock parameters were used for front paw and hind paw shock in the systemic naloxone experiments, stress per se clearly cannot be the crucial factor determining the involvement of endogenous opioids in footshock-induced analgesia. These results were discussed with respect to clinical treatments of pain which utilize somatosensory stimulation.

Dose-dependent analgesic and hyperalgesic effects of systemic naloxone in arthritic rats

The effects of various i.v. naloxone doses (10 microgram, 300 microgram, 600 microgram, 1 mg/kg) were studied upon vocalization threshold to foot-pressure in 30 normal rats and 70 rats with Freund's adjuvant-induced arthritis. In arthritic rats, the lowest naloxone doses yielded a clear increase in pressure required to trigger vocalization (i.e. were analgesic) while the highest dose (1 mg/kg) was hyperalgesic. In normal rats, naloxone never induced significant changes in the vocalization threshold.

Naloxone suppresses food/water consumption in the deprived cat

Intraperitoneal administration of the opiate antagonist, naloxone hydrochloride, resulted in decreased food and water consumption in drug-naive cats. In a cross-over Latin Square design, food consumed by six cats in a one hour period following 23 hours of deprivation, was decreased significantly below control (p less than 0.05) in linear relation to increasing dose (1 mg/kg and 10 mg/kg) of naloxone. Non-linear and time/order effects were not significant. Water consumption was decreased below control in a linear relation to increasing dose (1 and 10 mg/kg) for 5 of 6 cats at the 0.05 significance level. Non-linear and time/order effects on water consumption were not statistically significant for the same 5 cats. These results, and behavioral signs (i.e., vomiting, persistant vocalization, heavy salivation, mydriasis, moderate catatonia, and hissing) occasionally exhibited by four of the six cats in a 1-hr period following injection of the high dose, suggest a malaise-effect of naloxone.

[Abolition by naloxone of the inhibitory effect of peripheral electrical stimulation on the blink reflex]

The effects of a low frequency (2 c/sec) peripheral stimulation (electro-acupuncture, EA) on the nociceptive (R2) response of the blink reflex elicited by supra-orbital nerve stimulation (0.1 msec, 1 shock/8 sec) were studied in 10 healthy subjects. EA stimulation produced a very significant inhibition of the reflex in 8 subjects. Double-blind injection of naloxone (0.8 mg) reversed this inhibition while no signiificant change was observed with placebo. These results suggest that EA stimulation induces the release of endogenous opiates.

Differential effects of spinal cord lesions on narcotic and non-narcotic suppression of nociceptive reflexes: further evidence for the physiologic multiplicity of pain modulation

These studies examined the effects of bilateral lesions of the dorsolateral funiculus (DLF) of the rat spinal cord on the inhibition of a nociceptive reflex produced either by a systemic injection of 4 mg/kg of morphine or by a 20 sec exposure to 1.0 mA of transcutaneous electric shock. Reflex inhibition was quantified and analgesia inferred by use of a modified version of the D'Amour-Smith tail-flick test. Lesions which included only the DLF reduced morphine-produced analgesia (MA) by 73% but had no effect on shock-produced analgesia (SA) observed in the same rats. Baseline tail-flick latencies of this group were not affected by the lesions. Control lesions restricted to the dorsal columns attenuated neither MA nor SA. Lesions which included both the dorsal columns and DLF did not affect SA and produced no greater reduction in MA than lesions of the DLF alone. Previous work indicates that both MA and SA result, at least in part, from supraspinal activity. The current data indicate that: (1) supraspinal modulation participating in two different types of analgesic induction involves separate descending spinal pathways and (2) the maximal expression of analgesia produced by administration of narcotics requires the integrity of a supraspinal neural system projecting in the DLF.