Minervini Vanessa, France Charles P
Addiction Research, Treatment, & Training Center of Excellence.
Departments of Pharmacology.
Behav Pharmacol. 2020 Apr;31(2&3):233-248. doi: 10.1097/FBP.0000000000000551.
The opioid epidemic underscores the need for safer and more effective treatments for pain. Combining opioid receptor agonists with drugs that relieve pain through nonopioid mechanisms could be a useful strategy for reducing the dose of opioid needed to treat pain, thereby reducing risks associated with opioids alone. Opioid/cannabinoid mixtures might be useful in this context; individually, opioids and cannabinoids have modest effects on cognition, and it is important to determine whether those effects occur with mixtures. Delay discounting and delayed matching-to-sample tasks were used to examine effects of the mu-opioid receptor agonist morphine (0.32-5.6 mg/kg), the cannabinoid CB1/CB2 receptor agonist CP55940 (0.0032-0.1 mg/kg), and morphine/CP55940 mixtures on impulsivity (n = 3) and memory (n = 4) in rhesus monkeys. Alone, each drug decreased rate of responding without modifying choice in the delay-discounting task, and morphine/CP55940 mixtures reduced choice of one pellet in a delay dependent manner, with monkeys instead choosing delayed delivery of the larger number of pellets. With the exception of one dose in one monkey, accuracy in the delayed matching-to-sample task was not altered by either drug alone. Morphine/CP55940 mixtures decreased accuracy in two monkeys, but the doses in the mixture were equal to or greater than doses that decreased accuracy or response rate with either drug alone. Rate-decreasing effects of morphine/CP55940 mixtures were additive. These data support the notion that opioid/cannabinoid mixtures that might be effective for treating pain do not have greater, and might have less, adverse effects compared with larger doses of each drug alone.
阿片类药物流行凸显了对更安全、更有效疼痛治疗方法的需求。将阿片受体激动剂与通过非阿片类机制缓解疼痛的药物联合使用,可能是减少治疗疼痛所需阿片类药物剂量的有效策略,从而降低单独使用阿片类药物相关的风险。在这种情况下,阿片类/大麻素混合物可能会有所帮助;单独使用时,阿片类药物和大麻素对认知的影响较小,确定这些影响是否会在混合物中出现很重要。使用延迟折扣和延迟匹配样本任务来研究μ-阿片受体激动剂吗啡(0.32 - 5.6毫克/千克)、大麻素CB1/CB2受体激动剂CP55940(0.0032 - 0.1毫克/千克)以及吗啡/CP55940混合物对恒河猴冲动性(n = 3)和记忆(n = 4)的影响。单独使用时,每种药物在延迟折扣任务中均降低了反应率,但未改变选择,且吗啡/CP55940混合物以延迟依赖的方式减少了对一粒食物丸的选择,猴子转而选择延迟交付数量更多的食物丸。除了一只猴子的一个剂量外,单独使用任何一种药物均未改变延迟匹配样本任务的准确性。吗啡/CP55940混合物降低了两只猴子的准确性,但混合物中的剂量等于或大于单独使用任何一种药物时降低准确性或反应率的剂量。吗啡/CP55940混合物的降率作用是相加的。这些数据支持这样一种观点,即可能有效治疗疼痛的阿片类/大麻素混合物与单独使用较大剂量的每种药物相比,不会产生更大的不良影响,甚至可能产生更小的不良影响。