Opiate agonists and antagonists modulate taste perception in opiate-maintained and recently detoxified subjects

Abstract

Heroin addicts consume large quantities of refined sugars. This study investigated the effect of opiate use and antagonism on sweet taste in opiatemaintained drug users and detoxified former chronic opiate users, using a within-subject design.Seven opiate users received methadone and seven buprenorphine maintenance. Six detoxified subjects received naltrexone. Sucrose recognition thresholds and measurements of pleasantness and intensity were determined before and four hours after 1) a single dose of methadone or buprenorphine or 2) naltrexone. Control data were taken from a cohort of healthy volunteers including smokers.All measures of sweet and salt taste perception were significantly greater in opiate users and recently detoxified subjects compared to control subjects, with the exception of sweet pleasantness, which returned to control level after detoxification. Acute methadone administration reduced salt thresholds and unpleasantness to control levels. Increased sweet thresholds and salt unpleasantness in detoxified subjects were reversed by acute opioid antagonism, returning to control levels. These results suggest that opiate use and antagonism alters taste perception. Some of the alterations reverse on detoxification (sweet pleasantness), and others can be reversed by opioid antagonism (sweet threshold, salt unpleasantness). Changes in taste perception may underlie altered consumption of refined sugars in opiate users.

Heroin and saccharin demand and preference in rats

“…It may be that chronic exposure to heroin increases the value of sweet rewards, but only when those sweet rewards are not experienced in a state of withdrawal. This notion is consistent with the finding that opiate-dependent individuals maintained on methadone or buprenorphine, as well as recently detoxified former addicts (not opioid maintained and not experiencing withdrawal), rate sweet tastes as significantly more pleasant and more intense than do healthy controls (Green et al, 2013). …”

Opioid system and human emotions

“…In animals, μ receptor stimulation increases both the incentive motivation to seek food and the rewarding effects of food (Berridge et al, ), and the injection of μ receptor agonists into the mesolimbic reward system is rewarding in its own right (Bozarth and Wise, ). Opiate addicts perceive sweetness as more pleasant than drug‐naïve controls, and this effect is reversible by opioid antagonists (Langleben et al, ; Green et al, ). Similarly, in healthy volunteers, the opioid receptor blocker naloxone attenuates pleasure and concurrent BOLD responses to rewards in the anterior cingulate cortex (Petrovic et al, ).…”

Naltrexone alters the processing of social and emotional stimuli in healthy adults

“…Several studies have examined the effect of NTX on nonsocial rewards, such as food (Arbisi, Billington, & Levine, 1999; Fantino, Hosotte, & Apfelbaum, 1986; Green et al, 2013; Langleben, Busch, O’Brien, & Elman, 2012; Murray et al, 2014; Yeomans & Gray, 1996, 1997) and gambling wins (Petrovic et al, 2008). Consistent with the proposed broader role of the mu-opiate system in pleasure (Berridge et al, 2009), these studies suggest that NTX dampens positive responses to nonsocial rewards.…”