Abstract
The opioid epidemic was triggered by an overprescription of opioid analgesics. In the treatment of chronic pain, repeated opioid administrations are required which ultimately lead to tolerance, physical dependence, and addiction. A possible way to overcome this conundrum consists of a co-medication that maintains the analgesic benefits of opioids while preventing their adverse liabilities. YHS, the extract of the plant Corydalis yanhusuo, has been used as analgesic in traditional Chinese medicine for centuries. More recently, it has been shown to promote analgesia in animal models of acute, inflammatory, and neuropathic pain. It acts, at least in part, by inhibiting the dopamine D2 receptor, suggesting that it may be advantageous to manage addiction. We first show that, in animals, YHS can increase the efficacy of morphine antinociceptive and, as such, decrease the need of the opioid. We then show that YHS, when coadministered with morphine, inhibits morphine tolerance, dependence, and addiction. Finally, we show that, in animals treated for several days with morphine, YHS can reverse morphine dependence and addiction. Together, these data indicate that YHS may be useful as a co-medication in morphine therapies to limit adverse morphine effects. Because YHS is readily available and safe, it may have an immediate positive impact to curb the opioid epidemic.
Highlights
IntroductionOver the past two decades, dramatic increases in opioid overdose mortality have occurred in the United States and other nations
Introduction published maps and institutional affilOver the past two decades, dramatic increases in opioid overdose mortality have occurred in the United States and other nations
The opioid epidemic started with an increase in opioid prescriptions to treat chronic pain
Summary
Over the past two decades, dramatic increases in opioid overdose mortality have occurred in the United States and other nations. The opioid epidemic started with an increase in opioid prescriptions to treat chronic pain. Chronic pain is a therapeutic challenge and its management by opioids is controversial [2]. Opioids are administered for their superior analgesic effectiveness. Associated with repetitive opioid administration is the development of tolerance, which represents a loss of efficacy upon time [4]. Pain-afflicted patients require higher doses of opioids to maintain a mostly pain-free state, which in turn increases the risk of dependence, addiction, and fatal overdose [5,6]. Tolerance is monitored by quantifying analgesic responses over repeated opioid administration [7].
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