Department of Neuroscience, Farber Institute for Neurosciences, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Neuroscience. 2013 Sep 17;248:637-54. doi: 10.1016/j.neuroscience.2013.04.034. Epub 2013 Apr 24.
Withdrawal from opiates, such as heroin or oral narcotics, is characterized by a host of aversive physical and emotional symptoms. High rates of relapse and limited treatment success rates for opiate addiction have prompted a search for new approaches. For many opiate addicts, achieving abstinence may be further complicated by poly-drug use and co-morbid mental disorders. Research over the past decade has shed light on the influence of endocannabinoids (ECs) on the opioid system. Evidence from both animal and clinical studies point toward an interaction between these two systems, and suggest that targeting the EC system may provide novel interventions for managing opiate dependence and withdrawal. This review will summarize the literature surrounding the molecular effects of cannabinoids and opioids on the locus coeruleus-norepinephrine system, a key circuit implicated in the negative sequelae of opiate addiction. A consideration of the trends and effects of marijuana use in those seeking treatment to abstain from opiates in the clinical setting will also be presented. In summary, the present review details how cannabinoid-opioid interactions may inform novel interventions in the management of opiate dependence and withdrawal.
阿片类物质（如海洛因或口服麻醉品）戒断的特征是一系列令人不快的身体和情绪症状。阿片类药物成瘾的高复发率和有限的治疗成功率促使人们寻求新的方法。对于许多阿片类药物成瘾者来说，多药物使用和合并精神障碍可能使他们更难达到戒毒。过去十年的研究揭示了内源性大麻素（ECs）对阿片系统的影响。来自动物和临床研究的证据表明这两个系统之间存在相互作用，并表明针对 EC 系统可能为管理阿片类药物依赖和戒断提供新的干预措施。这篇综述将总结围绕大麻素和阿片类药物对蓝斑-去甲肾上腺素系统的分子作用的文献，蓝斑-去甲肾上腺素系统是一个关键的回路，与阿片类药物成瘾的负面后果有关。还将考虑在临床环境中寻求戒除阿片类药物的患者中使用大麻的趋势和影响。总之，本综述详细介绍了大麻素-阿片类药物相互作用如何为阿片类药物依赖和戒断的管理提供新的干预措施。
