Naloxone reduces alcohol intake in a free-choice procedure even when both drinking bottles contain saccharin sodium or quinine substances

Update on neuropharmacological treatments for alcoholism: scientific basis and clinical findings

The past decade has seen an expansion of research and knowledge on pharmacotherapy for the treatment of alcohol dependence. The Food and Drug Administration (FDA)-approved medications naltrexone and acamprosate have shown mixed results in clinical trials. Oral naltrexone and naltrexone depot formulations have generally demonstrated efficacy at treating alcohol dependence, but their treatment effect size is small, and more research is needed to compare the effects of different doses on drinking outcome. Acamprosate has demonstrated efficacy for treating alcohol dependence in European trials, but with a small effect size. In U.S. trials, acamprosate has not proved to be efficacious. Research continues to explore which types of alcohol-dependent individual would benefit the most from treatment with naltrexone or acamprosate. The combination of the two medications demonstrated efficacy for treating alcohol dependence in one European study but not in a multi-site U.S. study. Another FDA-approved medication, disulfiram, is an aversive agent that does not diminish craving for alcohol. Disulfiram is most effective when given to those who are highly compliant or who are receiving their medication under supervision. Of the non-approved medications, topiramate is among the most promising, with a medium effect size in clinical trials. Another promising medication, baclofen, has shown efficacy in small trials. Serotonergic agents such as selective serotonin reuptake inhibitors and the serotonin-3 receptor antagonist, ondansetron, appear to be efficacious only among certain genetic subtypes of alcoholic. As neuroscientific research progresses, other promising medications, as well as medication combinations, for treating alcohol dependence continue to be explored.

Evidence for the role of dopamine D3 receptors in oral operant alcohol self-administration and reinstatement of alcohol-seeking behavior in mice

The present study examined the effects of the acute intraperitoneal (i.p.) administration of the selective dopamine (DA) D(3) receptor antagonist SB-277011A (10, 20 or 30 mg/kg i.p.) on the oral operant self-administration of alcohol in male C57BL/6N mice. These effects were compared with those of naltrexone (0.5, 1 and 2 mg/kg i.p.) and acamprosate (100, 200 and 400 mg/kg i.p.). Compared with vehicle, the acute administration of SB-277011A (10 or 20 mg/kg) did not significantly alter the operant self-administration of alcohol, whereas the 30 mg/kg dose significantly reduced alcohol intake (g/kg), the number of reinforcers, and the number of active lever presses. The oral self-administration of alcohol was not significantly altered by the acute administration of either naltrexone or acamprosate, compared with vehicle-treated mice. SB-277011A, naltrexone and acamprosate were also tested in a model of drug/cue-triggered reinstatement of alcohol-seeking behavior. In this model, neither naltrexone (2 mg/kg) nor acamprosate (400 mg/kg) prevented relapse to alcohol-seeking behavior. In contrast, SB-277011A significantly reduced reinstatement of alcohol seeking in a dose-dependent manner. Provided these results can be extrapolated to humans, they suggest that selective DA D(3) receptor antagonists may be useful in the pharmacotherapeutic management of alcohol intake and prevention of relapse to alcohol-seeking behavior.

Reinforcing properties of ethanol in neonatal rats: involvement of the opioid system

Toward understanding why infant rats ingest high levels of ethanol without initiation procedures, the authors tested effects of mu and kappa receptor antagonists on ethanol reinforcement in neonatal rats. After an intracisternal injection of CTOP (micro antagonist), nor-Binaltorphimine (kappa antagonist), or saline, newborn (3-hr-old) rats were given conditioning pairings of an odor with intraorally infused ethanol or a surrogate nipple with ethanol administered intraperitoneally (to minimize ethanol's gustatory attributes). In each case, these opioid antagonists reduced or eliminated ethanol's reinforcement effect. The same effects occurred with saccharin as the reinforcer in olfactory conditioning. The results imply that activation of mu and kappa receptors, apparently acting jointly, is necessary for reinforcement or that antagonists of this activity impair basic conditioning.

Effects of estradiol treatment on voluntary and forced alcohol consumption in male rats

Estrogens have been related to alcohol as a dependent variable, but scarcely as a causal variable, that affects the alcohol consumption. The scope of the present work was to study the effect of estrogens on both the amount and the pattern of alcohol consumption. Male Wistar rats were individually exposed to forced alcohol consumption (FAC) and voluntary alcohol consumption (VAC) in each of the following four periods: precastration (PreC), postcastration (PosC) or post-sham castration, estradiol (E) treatment (5 microg of estradiol benzoate/day/rat) and postestradiol (PosE). Estrogenic treatment reduced significantly the alcohol consumption with respect to the PreC and PosE periods in castrated (C) males during VAC. E treatment showed the lowest value of alcohol intake in FAC, but differences were significant only with respect to PreC regardless of the male gonadal condition. E treatment decreased food intake regardless of the male gonadal condition in both FAC and VAC. Castration and E treatment modified differentially the patterns of alcohol consumption depending on the volitive characteristics of alcohol intake. Castration reduced the size of the licking rates without affecting the number of drinking bouts in FAC. This pattern was maintained in the E and PosE periods of C males. Castration did not affect the pattern of alcohol consumption in VAC, but estrogen reduced both the bout size and the number of bouts during the day, which gave an additional support to the inhibitory effect of estrogens on VAC. Results are discussed in terms of a possible inhibitory action of estrogens on the opioid system, which possibly reduces the rewarding properties of alcohol.

The role of opioid-dopamine interactions in the induction and maintenance of ethanol consumption

1. Alcohol is one of the most widely used recreational drugs, but also one of the most widely abused, causing vast economic, social and personal damage. 2. Several animal models are available to study the reinforcing mechanisms that are the basis of the abuse liability of ethanol. Innate differences in opioid or dopamine neurotransmission may enhance the abuse liability of ethanol, as indicated by animal and human studies. 3. Opioid antagonists have been shown to be effective, both experimentally and clinically, in decreasing ethanol consumption, presumably since ethanol induces the release of endogenous opioid peptides in vivo. However, ethanol may also stimulate the formation of opiate-like compounds, which could interact with opioid (or dopamine) receptors. Ethanol may cause changes in neurotransmission mediated via opioid receptors that determines whether alcohol abuse is more or less likely. 4. Ethanol appears to facilitate dopamine release by increasing opioidergic activity, disinhibiting dopaminergic neurons (by inhibition of GABAergic neurotransmission) via mu-opioid receptors in the ventral tegmental area (VTA) and delta-opioid receptors in the nucleus accumbens (NAcc). The effects of ethanol would be antagonised by presynaptic kappa-opioid receptors present on dopaminergic terminals in the NAcc. 5. Mesolimbic dopamine release induced by ethanol consumption seems to indicate ethanol-related stimuli are important, focussing attention on and enabling learning of the stimuli. However, studies indicate that there are redundant pathways, and neural pathways 'downstream' of the mesolimbic dopamine system, which also enable the reinforcing properties of ethanol to be mediated.

Discriminative stimulus effects of ethanol: neuropharmacological characterization

Generally, compounds discriminated by animals possess psychotropic effects in animals and humans. As with many other drugs of abuse, strength of the ethanol discriminative stimulus is dose related. The majority of studies show that doses close to 1.0 g/kg are close to the minimum at which the discrimination can be learned easily. Substitution studies suggest that anxiolytic, sedative, atactic, and myorelaxant effects of ethanol all play an important role in the formation of its intercoeptive stimulus. Low doses of ethanol produce more excitatory cues, similar to amphetamine-like subjective stimuli, whereas higher doses produce rather sedative/hypnotic stimuli similar to those elicited by barbiturates. Substitution studies have shown that the complete substitution for ethanol may be exerted by certain GABA-mimetic drugs acting through different sites within the GABA(A)-benzodiazepine receptor complex (e.g., diazepam, pentobarbital, certain neurosteroids), gamma-hydroxybutyrate, and antagonists of the glutamate NMDA receptor. Among the NMDA receptor antagonists both noncompetitive (e.g., dizocilpine) and competitive antagonists (e.g., CGP 40116) are capable of substituting for ethanol. Further, some antagonists of strychnine-insensitive glycine modulatory sites among the NMDA receptor complex (e.g., L-701,324) dose-dependently substitute for the ethanol discriminative stimulus. On the other hand, neither GABA-benzodiazepine antagonists nor NMDA receptor agonists produce contradictory effects (i.e., reduce the ethanol discriminative stimulus). There is influence of a particular training dose of ethanol on the substitution pattern of different compounds. For example, 5-HT(1B/2C) agonists substitute for intermediate (1.0 g/kg) but not higher (2.0 g/kg) ethanol training doses. Discrimination studies with ethanol and drugs acting on NMDA and GABA receptors consistently indicate asymmetrical generalization. For example, ethanol is able to generalize to barbiturates and benzodiazepines, but neither the benzodiazepine nor barbiturate response generalizes to ethanol. Only a few drugs are able to antagonize, at least to some extent, the discriminative stimulus of ethanol (e.g., partial inverse GABA-benzodiazepine receptor antagonist Ro 15-4513 and the opioid antagonist naloxone). The ethanol stimulus effect may be increased (i.e., stronger recognition) by N-cholinergic drugs (nicotine), dopaminergic drugs (apomorphine), and 5-HT3 receptor agonists (m-chlorophenylbiguanide). Thus, the ethanol stimulus is composed of the several components, with the NMDA receptor and GABA(A) receptor complex being of particular importance. This suggests that a drug mixture may be more capable of substituting for ethanol (or block its stimulus) than a single compound. The ability of drugs to substitute for the ethanol discriminative stimulus is frequently, although not preclusively, associated with the reduction of voluntary ethanol consumption. The examples of positive correlation are gamma-hydroxybutyrate, possibly memantine and certain serotonergic drugs such as fluoxetine. However, it remains uncertain to what extent the discriminative stimulus of ethanol can be seen as relevant in the understanding of the complex mechanisms of dependence.

Effects of moderate alcohol consumption on the central nervous system

The concept of moderate consumption of ethanol (beverage alcohol) has evolved over time from considering this level of intake to be nonintoxicating and noninjurious, to encompassing levels defined as "statistically" normal in particular populations, and the public health-driven concepts that define moderate drinking as the level corresponding to the lowest overall rate of morbidity or mortality in a population. The various approaches to defining moderate consumption of ethanol provide for a range of intakes that can result in blood ethanol concentrations ranging from 5 to 6 mg/dl, to levels of over 90 mg/dl (i.e., approximately 20 mM). This review summarizes available information regarding the effects of moderate consumption of ethanol on the adult and the developing nervous systems. The metabolism of ethanol in the human is reviewed to allow for proper appreciation of the important variables that interact to influence the level of exposure of the brain to ethanol once ethanol is orally consumed. At the neurochemical level, the moderate consumption of ethanol selectively affects the function of GABA, glutamatergic, serotonergic, dopaminergic, cholinergic, and opioid neuronal systems. Ethanol can affect these systems directly, and/or the interactions between and among these systems become important in the expression of ethanol's actions. The behavioral consequences of ethanol's actions on brain neurochemistry, and the neurochemical effects themselves, are very much dose- and time-related, and the collage of ethanol's actions can change significantly even on the rising and falling phases of the blood ethanol curve. The behavioral effects of moderate ethanol intake can encompass events that the human or other animal can perceive as reinforcing through either positive (e.g., pleasurable, activating) or negative (e.g., anxiolysis, stress reduction) reinforcement mechanisms. Genetic factors and gender play an important role in the metabolism and behavioral actions of ethanol, and doses of ethanol producing pleasurable feelings, activation, and reduction of anxiety in some humans/animals can have aversive, sedative, or no effect in others. Research on the cognitive effects of acute and chronic moderate intake of ethanol is reviewed, and although a number of studies have noted a measurable diminution in neuropsychologic parameters in habitual consumers of moderate amounts of ethanol, others have not found such changes. Recent studies have also noted some positive effects of moderate ethanol consumption on cognitive performance in the aging human. The moderate consumption of ethanol by pregnant women can have significant consequences on the developing nervous system of the fetus. Consumption of ethanol during pregnancy at levels considered to be in the moderate range can generate fetal alcohol effects (behavioral, cognitive anomalies) in the offspring. A number of factors--including gestational period, the periodicity of the mother's drinking, genetic factors, etc.--play important roles in determining the effect of ethanol on the developing central nervous system. A series of recommendations for future research endeavors, at all levels, is included with this review as part of the assessment of the effects of moderate ethanol consumption on the central nervous system.

The portacaval-shunted rat: a new model for the study of the mechanisms controlling voluntary ethanol consumption and ethanol preference?

Portacaval anastomosis (PCA) is a surgical procedure whereby blood from the portal vein is shunted into the inferior vena cava. PCA in the rat results in a significant increase (from 0.77 +/- 0.26 to 3.51 +/- 0.37 g of ethanol/kg/day) in voluntary ethanol consumption in a free-choice paradigm between water and 5% ethanol solution. After PCA surgery, increased voluntary ethanol consumption starts abruptly at 6 to 7 days and is maintained for > 28 weeks. Voluntary ethanol consumption in rats after PCA results in blood ethanol levels up to 158 mg%. After PCA, the ethanol preference ratio (defined as the percentage of total fluid intake constituted by ethanol) increased from 19 +/- 2% to 78 +/- 2% (P < 0.001). Administration of the nonselective opioid receptor antagonist naloxone (5 mg/kg, sc) resulted in a significant 6-fold attenuation of voluntary ethanol consumption by rats with PCA, an effect that was not mediated by an effect on locomotor activity. These findings, together with previous reports of widespread alterations of the mu- and delta-opioid receptors in the brain after PCA, suggest that increased voluntary ethanol consumption and ethanol preference in PCA rats may result from activation of the endogenous opioid system. Preliminary studies suggest that rats with PCA manifest behavioral signs consistent with the development of dependence. The portacaval-shunted rat may provide a useful preparation for the study of mechanisms, in particular those involving the liver, implicated in the development of increased voluntary ethanol consumption and ethanol preference.

Conference summary: Consensus Conference on Alcohol Dependence and the Role of Pharmacotherapy in its Treatment

Alcoholism, a major public health problem throughout the world, causes enormous damage to health and quality of life and undermines the well-being of families and society. It is associated with liver disease, cancer, cardiovascular problems, accidental deaths, suicides, and homicides. Because of the internationally recognized severity of this disease, this consensus conference was convened to bring together leading international experts to share ideas with regard to current research in the areas of alcohol dependency and treatment, and to discuss the future directions for the pharmacotherapy of alcoholism. The work presented at this conference points to a substantial evolution in the ability of researchers to understand the mechanism by which alcohol acts on the brain and reinforces the concept that alcoholism is a disease of brain chemistry, with a hereditary predisposition that is triggered by psychological and/or environmental factors that are thus far unidentified. The consensus statements proposed by the participants at the close of the conference highlight the definition, etiology, and prevention of alcoholism, as well as current and potential treatments and recommendations that can be used to guide future pharmacologic research.

The delta 2-opioid receptor antagonist naltriben selectively attenuates alcohol intake in rats bred for alcohol preference

The relative importance of different opioid receptor types in mediating alcohol drinking behavior compared with the intake of other ingesta can be determined by characterizing the effects of selective opioid antagonists on the intake of various ingesta. Nonselective opioid receptor antagonists suppress the intake of many ingesta including alcohol, food, water, and sweets. Two distinct subtypes of delta-opioid receptors, delta 1 and delta 2, have recently been identified in rodent brain. We have previously reported that naltrindole (NTI), which blocks both delta 1 and delta 2 receptors, suppresses both alcohol and saccharin intake in rats selectively bred for high alcohol preference (P line). We now report that naltriben (NTB), an opioid antagonist that is selective for delta 2-opioid receptors, suppresses alcohol intake in rats of the P line and the effect appears to be both specific for alcohol and independent of alcohol palatability. NTB may reduce alcohol intake by attenuating the reinforcing pharmacological properties of alcohol.

The delta opioid receptor antagonist naltrindole attenuates both alcohol and saccharin intake in rats selectively bred for alcohol preference

This study demonstrates that the selective delta receptor antagonists ICI 174864 and naltrindole (NTI) attenuate alcohol intake in a dose-dependent manner, without altering water intake, in rats selectively bred for alcohol preference. ICI 174864 had a very limited duration of action, as evidenced by the fact that suppression of alcohol intake lasted for only an hour following ICI 174864 administration. NTI, when administered in a dose of 10 mg/kg, suppressed alcohol intake by 28%. Increasing the dose of NTI to 15 mg/kg produced a 44% suppression of alcohol intake, but a further increase to 20 mg/kg did not produce greater suppression than was seen with a dose of 15 mg/kg (46% versus 44%, respectively). This suggests that NTI is maximally effective in suppressing alcohol intake at a dose of 15.0 mg/kg. NTI displayed a long duration of action, as evidenced by attenuation of alcohol drinking that lasted for at least 8 h following drug treatment. Administering the maximally effective dose of NTI (15 mg/kg) in two parts, separated by 4 h, served to prolong the duration of action of NTI and produced an attenuation of alcohol intake, but not water intake, that lasted for at least 28 h. The effect of NTI on alcohol intake was not specific for alcohol, as evidenced by the fact that NTI reduced the intake of saccharin solutions with and without alcohol.

Spontaneous and ethanol-stimulated in vitro release of beta-endorphin by the hypothalamus of AA and ANA rats

Previous studies demonstrated that both the spontaneous and ethanol-stimulated release of beta-endorphin (beta-EP) like-peptides (beta-EPLPs) by the hypothalami of the ethanol-preferring C57BL/6 mice is more pronounced than by the hypothalami of the ethanol-avoiding DBA/2 mice. The objective of the present studies was to investigate the effects of various concentrations of ethanol on the in vitro release of beta-EP peptides by the hypothalami of the ethanol-preferring Alko-Alcohol (AA) and ethanol-avoiding Alko Non-Alcohol (ANA) lines of rats. Results indicated that although the spontaneous release of hypothalamic beta-EPLPs was higher by the ANA than by the AA rats, the percentage increase following exposure to various concentrations of ethanol was similar in both lines of rats. Furthermore, the release of hypothalamic beta-EPLPs following exposure to 30 mM ethanol was significantly higher than the release following exposure to 10 mM ethanol in the AA, but not the ANA, rats. Analysis of the released beta-EPLPs with Sephadex G-75 and reversed phase HPLC indicated that the nonacetylated beta-EP 1-31 was the major component in the hypothalamic perifusates of the AA rats, whereas the shorter and acetylated forms of beta-EP were the predominant components in the hypothalamic perifusates of the ANA rats. Because the shorter and acetylated forms of beta-EP are devoid of opioid activity, their pronounced release by the hypothalami of the ANA rats may be important in maintaining their low ethanol consumption, even after long-term access to ethanol solutions.

Benzodiazepine receptor ligands modulate ethanol drinking in alcohol-preferring rats

The effects of benzodiazepine receptor ligands with different intrinsic activity profiles were studied on voluntary ethanol consumption in the selectively bred alcohol-preferring AA (Alko, Alcohol) rat line, and compared to those of an opiate antagonist, naloxone, and a serotonin uptake inhibitor, citalopram. The rats were first allowed to develop a strong preference for 10% (v/v) ethanol solution in tap water over plain water until their ethanol consumption stabilized. Thereafter, the period when ethanol solution was available for the rats was gradually reduced to 4 h, 3 times a week, every second working day. The acute effects of positive allosteric modulators (agonists) of the gamma-aminobutyric acid type A (GABAA)/benzodiazepine receptor [midazolam, abecarnil, ethyl 5-benzyloxy-4-methoxymethyl-beta-carboline-3-carboxylate (ZK 91296), bretazenil, and 2,5-dihydro-2-(4-methylphenyl)-3H-pyrazolo[4,3-C]quinolin-3(5H)-on e (CGS 9895)] and of negative allosteric modulators [inverse agonists, ethyl 8-azido-5,6-dihydro-5-methyl-6-oxo-4H-imidazo[1,5- a][1,4]benzodiazepine-3-carboxylate (Ro 15-4513) and t-butyl 5,6-dihydro-5-methyl-6-oxo-4H-imidazo[1,5-a]thieno[2,3- f][1,4]diazepine-3-carboxylate (Ro 19-4603)] were tested after i.p. injections of three different drug doses using saline injections as a control treatment. The benzodiazepine agonists had rather modest effects on ethanol intake, measured 1 and 4 h after the injections, whereas the inverse agonists and naloxone strongly decreased ethanol consumption. Acute citalopram had no clear effect on ethanol drinking, but it slightly decreased the consumption of novel food during the 4-h session, as did all other benzodiazepine agonists except bretazenil. Neither the inverse agonists nor naloxone had any significant effect on food intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Naltrexone reverses ethanol-induced dopamine release in the nucleus accumbens in awake, freely moving rats

The effect of the opioid receptor antagonist, naltrexone, on ethanol-induced changes in extracellular dopamine and serotonin in the nucleus accumbens was investigated using in vivo microdialysis in awake, freely moving rats. Locally applied ethanol (5% infused transprobe) resulted in substantial increases in dopamine in dialysate. Administration of naltrexone (cumulative dosing with 0.25-1.0 mg/kg i.p.) during ethanol administration dose-dependently reversed ethanol-induced increases in extracellular dopamine and its metabolite homovanillic acid but not serotonin. These data demonstrate an essential role for the endogenous opioid system in stimulation of dopamine release by ethanol in a brain area associated with reward and support the opioid system as a prime target for pharmacological modulation of the rewarding effects and consumption of ethanol.

Animal learning and motivation and addictive drugs

Highlights of a systematic analysis of the abstracts of over 1700 publications dealing with addictive drugs (primarily alcohol) in the context of animal learning and motivation are summarized under two main headings. The behavioral effects of drugs vary with the nature of the drug, the dosage, and the behavioral baseline; behavioral tolerance frequently results from continued practice in the drug state. The paradigmatic effects show that drugs can function effectively as conditional stimuli, unconditional stimuli, responses, and reinforcers. As a result, drug habits develop their own motivational support, leading to conditioned tolerance and conditioned addiction. It is contended that principles of animal behavior can provide a basis for a theory of human drug use and abuse, but that voluntary control of addictive behavior requires uniquely human cognitive processes.

Intracerebroventricular naltrexone treatment attenuates acquisition of intravenous cocaine self-administration in rats

The influence of centrally administered naltrexone, an opiate antagonist, on acquisition of intravenous cocaine self-administration behaviour in rats was examined. On five consecutive days, three hours per day, they could self-administer a cocaine solution (30 micrograms per infusion) through an indwelling cannula. Treatment consisted of daily injections of naltrexone (2 or 5 micrograms) or placebo into the lateral ventricle 30 minutes before testing. Naltrexone treatment dose dependently attenuated the rate of cocaine self-infusion. Both self-infusion rate and rate of responding on the reinforcement lever in the group treated with 5 micrograms naltrexone differed from placebo, whereas rate of responding on a dummy lever did not. These findings a) support the notion that opioid systems play a role in cocaine reinforcement, and b) suggest that naltrexone exerts its effect on cocaine reinforcement through action in the central nervous system.

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

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

Anatomical "circuitry" in the brain mediating alcohol drinking revealed by THP-reactive sites in the limbic system

The involvement of aldehyde adducts in the etiology of alcoholism continues to be supported by a number of experimental findings. These metabolites are synthesized endogenously from a condensation reaction of a biogenic aldehyde with a catechol- or indole-amine and act in the brain to augment or suppress the drinking of ethyl alcohol. When given by the intracerebroventricular route in an animal which does not prefer alcohol, certain tetrahydro-isoquinolines and beta-carbolines can augment significantly the voluntary intake of alcohol even in aversive concentrations. This paper describes the historical background and current status of the "Multiple Metabolite" theory of alcoholism. The recent identification of anatomical structures in the limbic-midbrain, limbic-forebrain of the Sprague-Dawley rat, which mediate changes in the intake of alcohol induced by tetrahydropapaveroline (THP) is also described. When injected in a low dose of 25 ng in a specific site, over a 3-day period, THP induces persistent increases in the intake of alcohol even in aversive concentrations. These THP-reactive sites comprise the substantia nigra, reticular formation, medial lemniscus, zona incerta, medial forebrain bundle, nucleus accumbens, olfactory tubercle, lateral septal nucleus, preoptic area, stria terminalis, and rostral hippocampus. A higher dose of 250 ng THP microinjected at homologous loci tends to inhibit the rat's self-selection of alcohol or exert no effect on drinking. Morphological mapping of histologically identified sites sensitive to THP revealed a distinct "circuitry" of neuronal structures overlapping both dopaminergic and enkephalinergic pathways. This "circuit" extends from the tegmental-nigral area of the midbrain rostrally to structures within the limbic-forebrain. When a THP-reactive structure, the N. accumbens, was lesioned by either of two neurotoxins, 6-hydroxydopamine or 5.7-dihydroxytryptamine, the rats' preference for alcohol increased sharply. This suggests that impairment of transmitter release, denervation supersensitivity or other perturbation of receptor function within this and other structures play a part in the aberrant drinking of alcohol. It is envisaged that a dopamine-enkephalin link underlies the mechanism for the onset, maintenance and permanency of alcohol preference generated by an aldehyde adduct. Finally, the "Two-Channel, Brain Metabolite" theory of alcoholism proposes that the transitory presence of an endogenously formed aldehyde adduct within cells of the brain causes a permanent perturbation of normal receptor processes and transmitter activity within synapses of specific structures of the limbic system. This theory thus explains the nature of the rewarding properties of alcohol as well as its complex addictive liability which is physiologically irreversible.

Ethanol and opiate decrease the axonal transport of substance-P like immunoreactive material in rat vagus-nerves

Since an enhanced retrograde axonal transport of receptor-bound opiate was observed in the ligated vagus nerves of rats treated chronically with alcohol, we decided to look at the anterograde axonal transport of substance P in the same experimental conditions and, after opiate administration. From 1 day up to 24 days' treatment with alcohol, we observed a decrease in the accumulation of substance P like immunoreactive material (SPLM) in rat ligated vagus nerves. Acute administration of lofentanil, an mu opiate agonist, caused the same reduction of anterograde axonal transport of SPLM and this effect could be prevented by naloxone. When naloxone or bezitramide, an opiate agonist, was given during the alcoholization period, the preference for alcohol in a choice test was reduced or prevented suggesting that opioid peptides are probably involved in chronic alcoholism. The present results support the idea that a common denominator could exist in drug addition and in chronic alcoholism and that substance P may be directly or indirectly involved.

Administration of leu-enkephalin impairs the acquisition of preference for ethanol

The effects of subcutaneous administration of leu-enkephalin (LEU-E) (10, 100 and 300 micrograms/kg) and LEU-E (100 micrograms/kg) plus naloxone (2.5 mg/kg) on ethanol preference and fluid intake have been investigated in rats. Under our procedural conditions, rats develop ethanol preference through forced ethanol drinking (conditioning session). Preconditioning administration of LEU-E induced a reduction of later ethanol preference. Post-conditioning administration of LEU-E (10 and 100 micrograms/kg) also attenuated the development of ethanol preference. NX antagonized the effects of LEU-E on ethanol preference and fluid consumption in the two experimental procedures used, indicating an involvement of opioid receptors in the LEU-E-induced impairment of the acquisition of ethanol preference.

Cholecystokinin and satiation with alcohol

Release of the brain-gut peptide cholecystokinin (CCK) is stimulated by intragastric instillation of ethanol, and peripheral administration of CCK inhibits ethanol consumption. To assess the temporal specificity of the inhibitory effect of CCK on alcohol intake, water-deprived rats were given 5% ethanol at 20, 10 or 0 min after intraperitoneal injections of CCK octapeptide. Delaying access to ethanol for 20 min prevented a significant effect of CCK on intake. CCK's temporally constrained inhibitory action on alcohol consumption is consistent with an ethanol satiation effect. To test the motivational specificity of CCK's effect on fluid intake, rats were allowed a 2-bottle choice of 2% ethanol and water after CCK injections. Ethanol solution intake was suppressed by CCK, and total water intake was unaffected. The putative alcohol satiation action of CCK is appropriately specific to ethanol solution in free-choice tests. Hungry, but not fluid-deprived rats that were either ethanol experienced or naive received a 2-bottle choice of 4% ethanol or water after CCK or saline injections. CCK again specifically inhibited ethanol intake, but this effect required prior ethanol experience. Doses of CCK and naloxone, an opioid receptor blocker, combined to inhibit ethanol intake in an infra-dose-additive manner in water-deprived rats. CCK may act endogenously, in part on opioid receptor-mediated processes, as a preabsorptive satiety signal of ethanol. The full expression of this action appears to depend on prior conditioning of nutritive expectancy of the postingestive effects of alcohol.

Beta-endorphin administration interferes with the acquisition and initial maintenance of ethanol preference in the rat

Attention has been focused on the possibility of an interaction between the endorphinergic system and ethanol intake. In the present study, the effects of subcutaneous (SC) administration of beta-endorphin (beta-E) (0.25, 1 and 5 micrograms/kg) and/or naloxone (NX) (1 or 2.5 mg/kg) on ethanol preference (EP) have been investigated in rats. Under our procedural conditions, rats developed ethanol preference (EP) by a forced ethanol drinking session (conditioning session). Preconditioning administration of beta-E (1 microgram/kg) reduced later EP. When beta-E was administered postconditioning, the opioid affects ethanol preference depending on the dose: both 0.25 micrograms/kg and 5 microgram/kg reduced EP, but the dose of 1 microgram/kg did not alter it. Administration of beta-E (1 and 5 micrograms/kg) before the first testing session attenuated EP. NX antagonized the effects of beta-E on EP in the three experimental procedures used, indicating that mu-opioid receptors might be involved in the beta-E-induced reductions on EP. Our results provide further evidences for a beta-endorphinergic system involvement on the mechanism leading to consumption of ethanol.

Naloxone, but not Tyr-MIF-1, reduces volitional ethanol drinking in rats: correlation with degree of spontaneous preference

The possible relationship between the actions of ethanol and opiates led us to examine the effect of opiate antagonists on ethanol intake in rats with a free choice of water. Naloxone (NAL) significantly reduced intake of ethanol. This effect was much greater in "high-preferring" (ethanol/total fluid intake greater than 60%) than in "low-preferring" (ethanol/total fluid intake less than 30%) rats. Furthermore, a correlation was found between the degree of spontaneous preference (ethanol/total fluid intake ratio) and the reduction of ethanol drinking by NAL. Sensitivity to NAL increased with increased preference for ethanol. Neither Tyr-MIF-1 (Tyr-Pro-Leu-Gly-NH2) nor MIF-1 (Pro-Leu-Gly-NH2) caused a significant modification of ethanol intake. This study shows that NAL can reduce volitional ethanol intake in rats and provides further evidence that Tyr-MIF-1 does not always act like NAL.

Effect of lesions of the dorsalis raphe nuclei on the initiation of alcohol preference in rats

In this report, the effect of lesion of the dorsalis raphe nuclei (DR) by stereotaxic injection of kainic acid on the initiation of voluntary ethanol consumption is described for male rats. After a 30-day recovery period DR- and control-rats were exposed to a 0.2% saccharin sodium--water--5% ethanol free choice test (8 days) for the first time. This three-choice paradigm revealed a positive preference for ethanol (50.5%) vs. saccharin (29.5%) and water (20.0%) in control rats. However, in the group showing histological evidence of DR lesion there was no preference for ethanol (25.7%) whereas total fluid intake/8 days was not affected. These findings suggest a specific effect of the DR lesion on ethanol preference in naive rats. In addition, the within-group analysis of data revealed that such effects were due to an increase in the population of spontaneous non-alcohol-preferring subjects (ethanol preference between 0 and 20%) and to prevention of alcohol-preferring rats (ethanol preference between 80-100%). The depletion of brain serotonin (5-HT) found in the forebrain of the DR-lesioned rats suggests that 5-HT pathways projecting from the DR neurons may be involved in these effects. The fact that forebrain noradrenalin was not affected would rule out involvement of lesions of locus coeruleus-noradrenalin neurons by diffusion of kainic acid. However, the eventual lesion of peptide neurons in the periventricular gray substance surrounding the DR nuclei cannot be discounted.

Naloxone decreases ethanol consumption within a free choice paradigm in rats

The effect of subcutaneous naloxone administration on the consumption of a weak ethanol solution in rats on the three consecutive days (testing days) was investigated using a behavioral paradigm which includes a first forced ethanol exposure (conditioning day) followed by a two-bottle ethanol/water choice procedure. Besides reducing fluid intake, naloxone treatment prior to forced ethanol exposure interferes with the acquisition of ethanol preference. Post-conditioning naloxone administration fails to affect ethanol preference. Administration of naloxone prior to the first testing session induces a reduction on total fluid intake, at the day of treatment; a decrease on ethanol preference throughout the three consecutive testing days is also observed with the higher dose of the antagonist (5 mg/kg). An involvement of endogenous opioids in ethanol consumption is suggested through the modulation of alcohol reinforcement or the affective quality of the gustatory cue.

Enhanced axonal transport of receptor-bound opiate in ethanol-treated rats

The retrograde transport of receptor-bound opiate was markedly enhanced in the vagus nerves of rats housed for 25 days in an atmosphere of ethanol vapor. This increase disappeared after 8 days of withdrawal as did the animal preference for ethanol. In contrast, the axonal transport of muscarinic receptors in sciatic nerves was slightly reduced. This provides more evidence for the idea that chronic alcoholization and morphine addiction share a common denominator and that the retrograde transport of receptor-bound signal molecules represents a link between the synapses and the cell-body of neurones.

Selected opioids modify intake of sweetened ethanol solution among female rats

Water-deprived female rats were given a daily, 1.5-hr opportunity to take either a sweetened ethanol solution or water. Across days, they increased their intake of ethanol solution and had stable intakes of about 2 g of pure ethanol/kg after 3 weeks. Morphine (1.0 mg/kg) alone, and in combination with diprenorphine (25 micrograms/kg), increased intake of ethanol solution among females similar to the increased intake seen with males under similar procedures. Fentanyl dose-relatedly increased intake of ethanol. The data strengthen the idea that one or more of the endogenous opioid systems, but not all, are involved with instances of "excessive" intake of alcoholic beverages.

Antagonism by naltrexone of voluntary alcohol selection in the chronically drinking macaque monkey

An opiate receptor antagonist can reduce excessive alcohol drinking in the rat previously given intracerebroventricular (ICV) infusions of a tetrahydroisoquinoline. Recently, it was found that cerebrospinal fluid (CSF) obtained from volunteers or human patients and subsequently injected ICV in macaque monkeys markedly alters the voluntary consumption of ethyl alcohol in certain of these primates. The purpose of the present study was to determine whether an opioid antagonist would affect the pattern of alcohol intake in selected monkeys which drank excessive amounts of alcohol. Initially, the preferred concentration of alcohol was determined individually for each monkey which consistently drank from 3.0-6.0 g/kg alcohol per day. Subsequently, the single concentration, which ranged from 5-15%, was offered together with water during three consecutive periods as follows: (1) 4-day control baseline period; (2) a 3-day interval during which a saline control vehicle or 0.6 or 1.2 mg/kg naltrexone was administered subcutaneously at 0900 and 1700 hours; and (3) a final 4-day post-injection period during which the alcohol-water preference test was continued. The results showed that both doses of naltrexone significantly attenuated voluntary alcohol drinking up to 60% of the baseline intake during the 3 days of its administration. In two monkeys, alcohol drinking continued to be suppressed up to 50% of basal intake during all or a part of the 4-day post-naltrexone interval. These findings suggest that an opiate receptor mechanism in the brain could be partially involved in the action of the chemical constituents of the human's CSF which serve to induce an abnormally high intake of alcohol in the infra-human primate.

Role of pituitary and related neuropeptides in alcoholism and pharmacodependence

Evidence is accumulating that hormonal systems present in the pituitary and the brain play a critical role in behavioral homeostase. The hormones and their fragments, called neuropeptides, produced by these systems modulate neurotransmitter activity and thereby control brain functions. Disturbances in this hormonal control may result in psychopathology, including addiction. Vasopressin and related peptides decrease under certain conditions addictive behavior of experimental animals and humans and brain reward. The pituitary and brain opioid peptides are candidates to play an essential role in reward processes and may be common factors in addiction to various psychoactive drugs, including heroin and alcohol, and to habits. Other pituitary hormones, like ACTH, gamma 2-MSH and prolactin have also been implicated in brain reward and drug addiction. It is postulated that disturbances in the hormonal and neuropeptide systems may lead to a state in which addiction behavior can easily be elicited and that the hormonal climate in the body may be of relevance for the individual susceptibility to addictive drugs. It is proposed to analyse the relation between hormonal systems and addictive behavior.

Endogenous opiates: 1984

This paper is the seventh in an annual series of reviews of research involving the endogenous opiate peptides, each installment being restricted to work published during the previous year. As in the past three years, the review this year is limited to non-analgesic and behavioral studies of the opiate peptides. The specific topics this year include: stress, tolerance and dependence, consummatory responses, gastric and renal activity, alcohol, mental illness, learning and memory, cardiovascular responses, respiratory effects, thermoregulation, seizures and neurological disorders, activity, and miscellaneous other topics.