Interaction of the cannabinoid and opioid systems in the modulation of nociception
- PMID: 19367508
- DOI: 10.1080/09540260902782794
Interaction of the cannabinoid and opioid systems in the modulation of nociception
Abstract
Cannabinoids and opioids produce antinociceptive synergy. Cannabinoids such as Delta-9-tetrahydrocannabinol (THC) release endogenous opioids and endocannabinoids such as anandamide (AEA) also alter endogenous opioid tone. Opioids and cannabinoids bind distinct receptors that co-localize in areas of the brain involved with the processing of pain signals. Therefore, it is logical to look at interactions of these two systems in the modulation of both acute and chronic pain. These drugs are often co-abused. In addition, the lack of continued effectiveness of opioids due to tolerance development limits the use of such drugs. The cost to society and patients in terms of dollars, loss of productivity, as well as quality of life, is staggering. This review summarizes the data indicating that with cannabinoid/opioid therapy one may be able to produce long-term antinociceptive effects at doses devoid of substantial side effects, while preventing the neuronal biochemical changes that accompany tolerance. The clinical utility of modulators of the endocannabinoid system as a potential mimic for THC-like drugs in analgesia and tolerance-sparing effects of opioids is a critical future direction also addressed in the review.
Similar articles
-
Endocannabinoids and pain: spinal and peripheral analgesia in inflammation and neuropathy.Prostaglandins Leukot Essent Fatty Acids. 2002 Feb-Mar;66(2-3):243-56. doi: 10.1054/plef.2001.0362. Prostaglandins Leukot Essent Fatty Acids. 2002. PMID: 12052040 Review.
-
Cannabinoid transmission and pain perception.Neurobiol Dis. 1998 Dec;5(6 Pt B):447-61. doi: 10.1006/nbdi.1998.0218. Neurobiol Dis. 1998. PMID: 9974177 Review.
-
Cannabinoids:their role in pain and palliation.J Pain Palliat Care Pharmacother. 2007;21(3):19-28. J Pain Palliat Care Pharmacother. 2007. PMID: 18032352 Review.
-
Opioid analgesia: perspectives on right use and utility.Pain Physician. 2007 May;10(3):479-91. Pain Physician. 2007. PMID: 17525783 Review.
-
[Pain relief with cannabinoids-- the importance of endocannabinoids and cannabinoids for pain therapy].Anasthesiol Intensivmed Notfallmed Schmerzther. 2008 Jul;43(7-8):522-8. doi: 10.1055/s-0028-1083094. Anasthesiol Intensivmed Notfallmed Schmerzther. 2008. PMID: 18671173 Review. German.
Cited by
-
Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18-64 years.Addict Behav. 2024 Jun;153:107983. doi: 10.1016/j.addbeh.2024.107983. Epub 2024 Feb 10. Addict Behav. 2024. PMID: 38367507
-
Understanding the endocannabinoid system as a modulator of the trigeminal pain response to concussion.Concussion. 2017 Oct 4;2(4):CNC49. doi: 10.2217/cnc-2017-0010. eCollection 2017 Dec. Concussion. 2017. PMID: 30202590 Free PMC article. Review.
-
PnPP-15, a Synthetic Peptide Derived from a Toxin from Phoneutria nigriventer Spider Venom, Alleviates Diabetic Neuropathic Pain and Acts Synergistically with Pregabalin in Mice.Toxins (Basel). 2023 Sep 7;15(9):560. doi: 10.3390/toxins15090560. Toxins (Basel). 2023. PMID: 37755986 Free PMC article.
-
Safety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humans.J Addict Med. 2015 May-Jun;9(3):204-10. doi: 10.1097/ADM.0000000000000118. J Addict Med. 2015. PMID: 25748562 Free PMC article. Clinical Trial.
-
Positive allosteric modulation of the cannabinoid type-1 receptor (CB1R) in periaqueductal gray (PAG) antagonizes anti-nociceptive and cellular effects of a mu-opioid receptor agonist in morphine-withdrawn rats.Psychopharmacology (Berl). 2020 Dec;237(12):3729-3739. doi: 10.1007/s00213-020-05650-5. Epub 2020 Aug 28. Psychopharmacology (Berl). 2020. PMID: 32857187 Free PMC article.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
