Polydrug Definition and Assessment: The State of the Art

Font‐Mayolas, Sílvia; Calvo, Fran

doi:10.3390/ijerph192013542

Cited by 4 publications

(2 citation statements)

References 58 publications

(59 reference statements)

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“…Polydrug use is a common condition among addicted patients [80], suggesting that a shared genetic vulnerability underlies different addictions. The results obtained with UChB rats, which self-administer ethanol, nicotine, and now opioids, support this concept and are in line with previous reports showing that the alcohol-naïve offspring of alcohol-preferring (P) rats selectively bred for high alcohol intake self-administered high amounts of nicotine compared to non-alcohol-preferring (NP) rats [81].…”

Section: Discussionmentioning

confidence: 99%

Chronic Voluntary Morphine Intake Is Associated with Changes in Brain Structures Involved in Drug Dependence in a Rat Model of Polydrug Use

Quintanilla,

Morales,

Santapau

et al. 2023

IJMS

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Chronic opioid intake leads to several brain changes involved in the development of dependence, whereby an early hedonistic effect (liking) extends to the need to self-administer the drug (wanting), the latter being mostly a prefrontal–striatal function. The development of animal models for voluntary oral opioid intake represents an important tool for identifying the cellular and molecular alterations induced by chronic opioid use. Studies mainly in humans have shown that polydrug use and drug dependence are shared across various substances. We hypothesize that an animal bred for its alcohol preference would develop opioid dependence and further that this would be associated with the overt cortical abnormalities clinically described for opioid addicts. We show that Wistar-derived outbred UChB rats selected for their high alcohol preference additionally develop: (i) a preference for oral ingestion of morphine over water, resulting in morphine intake of 15 mg/kg/day; (ii) marked opioid dependence, as evidenced by the generation of strong withdrawal signs upon naloxone administration; (iii) prefrontal cortex alterations known to be associated with the loss of control over drug intake, namely, demyelination, axonal degeneration, and a reduction in glutamate transporter GLT-1 levels; and (iv) glial striatal neuroinflammation and brain oxidative stress, as previously reported for chronic alcohol and chronic nicotine use. These findings underline the relevance of polydrug animal models and their potential in the study of the wide spectrum of brain alterations induced by chronic morphine intake. This study should be valuable for future evaluations of therapeutic approaches for this devastating condition.

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Section: Discussionmentioning

confidence: 99%

Chronic Voluntary Morphine Intake Is Associated with Changes in Brain Structures Involved in Drug Dependence in a Rat Model of Polydrug Use

Quintanilla,

Morales,

Santapau

et al. 2023

IJMS

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“…Polydrug use is an umbrella term with different definitions across studies [1 ▪ ], comprising both concurrent and simultaneous polydrug use, that is, using multiple drugs in a prespecified period (e.g., 1 year) and using multiple drugs at the same time, respectively. Polydrug use is associated with the onset and persistence of substance use disorders (SUD), low treatment retention and negative treatment outcomes in treatment seeking drug users [2,3].…”

Section: Introductionmentioning

confidence: 99%

Predictors and motives of polydrug use in opioid users. A narrative review

Amsterdam

Pierce

Brink

2023

Current Opinion in Psychiatry

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Purpose of reviewTo review the recent literature on predictors and personal motives of polydrug use in opioid users with a focus on combined use of opioids with stimulants, benzodiazepines and gabapentinoids.Recent findingsIn North America, methamphetamine is now the most prevalent co-drug in opioid users and is responsible for high mortality rates. In Europe, opioids are rather combined with either cocaine, benzodiazepines or gabapentionoids, but recent data are lacking.Main personal motives of opioid users to combine opioids with methamphetamine or cocaine is to boost the opioid high, inhibit the withdrawal effects of heroin and have a cheaper alternative to maintain the opioid high. Risk factors of polydrug use by opioid users included being male, younger age, homelessness, high-risk sexual behavior, needle sharing, incarceration, poor mental health and recent use of cocaine or prescription opioids. The motives for co-use of opioids and gabapentinoids also include seeking a better high, lower price and to self-medicate pain/physical symptoms, including those resulting from withdrawal.SummaryWhen treating opioid users with polydrug drug use, special attention should be paid to dosing when in opioid agonist methadone/buprenorphine treatment and to the presence of physical pain. The validity of part of the personal motives seems questionable which deserves attention when counselling opioid users with polydrug use.

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