Bradykinin and Pain

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Abstract

Basic biomedical research attempts to understand bodily functions, but the implicit or explicit underlying assumption is that new information is being sought so as to discover more effective and safer therapies. How does molecular research into the addictive processes fit into this model? Addiction takes place to a wide variety of psychoactive substances, all of which seem to share the capacity to provide behavioral reinforcement, some enhanced sense of well-being, or euphoria. Along with their sedative effects, alcohol and barbiturates provoke euphoria in susceptible individuals. The stimulant actions of cocaine and amphetamines might in principle have therapeutic actions except for the addictive propensity associated with the euphoric actions of the drugs. Similarly, opiates, besides providing analgesia, elicit reinforcing subjective effects. The phenomena of tolerance, physical dependence, and compulsive drug-seeking behavior are common to addiction involving all of the dependence-producing substances. Because of the similarity in formal properties of the addictive process across different drug classes, it is conceivable that the same or closely similar general mechanism is involved in addiction to all drugs, although each utilizes distinct neurochemical mediators. Viewed optimistically, if one could solve the riddle of addiction to one substance, then the mystery of addiction for all classes of drugs would be revealed. From a more pessimistic vantage point, one might be concerned that most, if not all, agents that make us “feel good” seem to have abuse liability if not the capacity to cause serious addiction. In principle, sedating, antianxiety, stimulant, and central analgesic drug actions might be elicited by chemicals without provoking the enhanced sense of well-being that seems linked to abuse potential. However, up to the present time virtually all centrally acting drugs that convey these potentially therapeutic actions present addictive liabilities.