The effects of a cold-water immersion stressor on the reinforcing and subjective effects of fentanyl in healthy volunteers

Zacny, James P.; McKay, M.; Toledano, Alicia Y.; Marks, Sandy C.; Young, C.; Klock, P. Allan; Apfelbaum, Jeffrey L.

doi:10.1016/0376-8716(96)01274-4

Cited by 42 publications

(32 citation statements)

References 41 publications

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“…Söderpalm and de Wit (2002) found that social stress reduced the stimulant-like effects of alcohol and increased self-reports of sedation. Zacny et al (1996) and Conley et al (1997 reported that brief exposure to a coldwater stressor dampened or abolished the subjective (including euphorigenic) effects of opioids fentanyl and morphine. The range of conditions under which stress dampens or enhances subjective drug effects remains to be determined.…”

Section: Discussionmentioning

confidence: 97%

Effects of stress on responses to methamphetamine in humans

2003

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Section: Discussionmentioning

confidence: 97%

Effects of stress on responses to methamphetamine in humans

2003

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“…Although it is felt (Hutcheson et al, 2001) that intrinsic reward is required for self-administration at least at the time of its acquisition, evidence cited above indicates that even a first opioid injection causes lasting pain. In drug-naive volunteers, opioid self-administration occurs only to the extent that they receive painful stimulation, and the latter abolishes opioid-induced, positive-affect "elation" (Zacny et al, 1996). Thus, as suggested above with opioid CPP, opioid self-administration may at least partly be driven by opioid onset cues that predict the relief, however short-lived, of opioid pain.…”

Section: -Htmentioning

confidence: 88%

High-Efficacy 5-Hydroxytryptamine 1A Receptor Activation Counteracts Opioid Hyperallodynia and Affective Conditioning

Colpaert

Deseure²,

Stinus³

et al. 2005

J Pharmacol Exp Ther

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Pain may become intractable as tolerance develops to opioids and the opioids, paradoxically, induce pain. We examined the hypothesis that the analgesia produced by the novel analgesic and high-efficacy 5-hydroxytryptamine (5-HT) 1A receptor agonist (3-chloro-4-fluoro-phenyl)-[4-fluoro-4-{[(5-methyl-pyridin-2-ylmethyl)-amino]methyl}piperidin-1-yl]methanone, fumaric acid salt (F 13640) may counteract opioid-induced pain. In studies of the somatosensory quality of pain in infraorbital nerve-injured rats, morphine infusion (5 mg/day) by means of osmotic pumps initially caused analgesia (i.e., decreased the behavioral response to von Frey filament stimulation), followed by hyperallodynia and analgesic tolerance. Infusion of F 13640 (0.63 mg/day) prevented the development of opioid hyperallodynia and reversed opioid hyperallodynia once established. In studies of the affective/motivational quality of pain, F 13640 both prevented and reversed the conditioned place aversion induced by naloxone (0.04 mg/kg i.p.) in morphine-infused rats; F 13640 also prevented and reversed the conditioned place preference induced by morphine injections (7.5 mg/kg i.p.). The data confirm that opioids produce bidirectional hypo-and proalgesic actions, and offer initial evidence that high-efficacy 5-HT 1A receptor activation counteracts both the sensory and the affective/motivational qualities of opioid-induced pain. The data also indicate that F 13640 may be effective with opioidresistant pain. It further is suggested that opioid addiction may represent self-therapy of opioid-induced pathological pain.Although opioids produce powerful pain relief, pain may become intractable as tolerance develops to opioid analgesia; it has been proposed that this is because opioids may, paradoxically, induce pain. Indeed, a concept of signal transduction in central pain-processing systems (Colpaert, 1996) specifies that any input to such systems causes not a single effect but two dual effects that are bidirectional, or opposite in sign. Thus, morphine eventually causes not only analgesia as a "first order" effect but also a "second order" hyperalgesia that outlasts opioid receptor activation for some time. Upon chronic opioid exposure, the second order pain, or sensitization to nociceptive input, grows and neutralizes the first order analgesia. Considerable evidence now indicates that tolerance to opioid analgesia results from opioid-induced pain ("opioid pain"; here used to refer to hyperalgesia, allodynia, and hyperallodynia; Colpaert, 1996;Mao, 2002;Ossipov et al., 2003).Opioid pain is comprehensive, encompassing both the "physiological" (e.g., nociceptive) and the more recently identified (Scholz and Woolf, 2002) "pathological" (e.g., neuropathic) types of pain. Indeed, opioids not only produce hyperalgesia (i.e., an enhanced response to nociceptive stimulation; Colpaert, 1996) but also neuropathic-like allodynia (i.e., pain behaviors in response to innocuous stimuli; Ossipov et al., 2003). In human, opioid pain occurs after the intraoperative ...

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“…The analgesic effects of oxycodone and Bup/Nx also were evaluated with experimentally induced pain using the CPT, a commonly used and well-established model for producing pain (Comer et al, 2009;Zacny et al, 1996). Crushed ice was added to the cold tank, and warm water was placed in the warm tank.…”

Section: Apparatus and Questionnairesmentioning

confidence: 99%

“…To date, there have been few investigations in the peer-reviewed literature characterizing the subjective and reinforcing effects of opioids in patients with chronic pain. Pain has been shown to modulate the subjective effects of opioids in some studies (Zacny et al, 1996), but few studies have attempted to quantify the subjective effects of opioids among chronic pain sufferers (Lasagna et al, 1955). A more comprehensive assessment of the effects of opioids among patients with chronic pain may provide critical insight into the motivating factors behind opioid abuse within this particular population.…”

Section: Introductionmentioning

confidence: 99%

The Subjective, Reinforcing, and Analgesic Effects of Oxycodone in Patients with Chronic, Non-Malignant Pain who are Maintained on Sublingual Buprenorphine/Naloxone

Jones

Sullivan

Manubay

et al. 2010

Neuropsychopharmacol

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Some sources suggest that significant misuse of opioid drugs exists among patients with chronic pain. However, the risk factors and motivation behind their abuse may differ from those of other opioid abusers. This study sought to examine the abuse liability of oxycodone among patients with chronic, non-malignant pain who met the DSM-IV criteria for opioid abuse. Eighteen opioid-dependent patients with chronic pain lived on an in-patient unit of the New York State Psychiatric Institute during the 7-week study. Participants were given oral oxycodone (0, 10, 20, 40, and 60 mg/70 kg) while maintained on various doses of sublingual buprenorphine/naloxone (Bup/Nx; 2/0.5, 8/2, and 16/4 mg/day). Doses of both medications were administered under double-blind conditions. Oxycodone produced an overall positive, but less robust, subjective profile than previously reported in recreational opioid users without pain. Furthermore, unlike our findings in recreational opioid users and more similar to effects in non-drug-abusing individuals, oxycodone failed to serve as a reinforcer. As for the maintenance drug, Bup/Nx produced a dose-related reduction in some of the effects of acutely administered oxycodone. These data suggest that sublingual Bup/Nx has the potential as an analgesic medication and further research should investigate its use in treating patients with chronic pain who abuse opioids.

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The effects of a cold-water immersion stressor on the reinforcing and subjective effects of fentanyl in healthy volunteers

Cited by 42 publications

References 41 publications

Effects of stress on responses to methamphetamine in humans

Effects of stress on responses to methamphetamine in humans

High-Efficacy 5-Hydroxytryptamine 1A Receptor Activation Counteracts Opioid Hyperallodynia and Affective Conditioning

The Subjective, Reinforcing, and Analgesic Effects of Oxycodone in Patients with Chronic, Non-Malignant Pain who are Maintained on Sublingual Buprenorphine/Naloxone

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