Abstract
Opioid addiction is classified as a substance use disorder (SUD), a complex and chronic health condition with physical, social, and psychological consequences. While there is no cure for it, we present a novel approach towards preventing a hallmark feature of addiction-- the opiate withdrawal syndrome.
Highlights
The Rise of the Opioid EpidemicMorphine is a legally prescribed opioid analgesic, and as the first alkaloid isolated from opium by German pharmacist Friedrich Sertürner in the early 1800s, it is the standard by which other opioids are tested [1,2]
It was during this decade that the incidence of first time opioid analgesic abuse rose from 628,000 individuals in 1990 to 2.4 million in 2001 [3]
Tsutsumi et al [93] reported how a patient who was receiving cyclosporine after a stem cell transplant had improved pain relief from transdermal fentanyl but developed withdrawal symptoms after fentanyl discontinuation. When this patient was switched to morphine, she did not develop withdrawal symptoms after morphine discontinuation. This finding is consistent with our studies showing that cyclosporine A administered before repetitive morphine administration significantly reduces naloxone-induced withdrawal syndrome [41,42,59,94] (Figure 3)
Summary
The Rise of the Opioid EpidemicMorphine is a legally prescribed opioid analgesic, and as the first alkaloid isolated from opium by German pharmacist Friedrich Sertürner in the early 1800s, it is the standard by which other opioids are tested [1,2]. If the immune system facilitates the effect of opioids, perhaps immunomodulation before opioid administration can prevent tolerance and withdrawal. This review presents studies using immunomodulators alpha interferon, cyclosporine A, and cortisol before repetitive morphine administration to curb opioid withdrawal.
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