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Acute opioid dependence: characterizing the early adaptations underlying drug withdrawal

Psychopharmacology volume 178, pages 353–366 (2005)Cite this article

Abstract

Rationale

While opioid withdrawal is typically studied under conditions of chronic (i.e., continuous) drug administration, withdrawal signs can also be demonstrated in both humans and animals after a single opioid exposure. This phenomenon, termed acute dependence, may be useful in understanding the early stages of opioid dependence and addiction.

Objective

This review provides an overview of acute dependence by comparing withdrawal from acute and chronic opioid exposure across dimensions ranging from symptomatology to neural substrates. Assessment of repeated withdrawals from acute opioid administration is also presented as a tool for better understanding the adaptive changes induced by multiple drug exposures.

Conclusions

Although not identical phenomena, acute and chronic dependence share a number of characteristics. Examining potentiations of withdrawal severity across multiple acute opioid exposures may be especially valuable in characterizing the development of drug dependence. Further study of acute dependence promises to lead to more effective treatments for opioid withdrawal and addiction.

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Notes

  1. This review does not examine acute tolerance, or the diminished response to subsequent opioid administration following a single opioid exposure (Yano and Takemori 1977; Fairbanks and Wilcox 1997). While some authors assert that opioid tolerance and dependence reflect similar adaptive changes (Nielsen and Sparber 1985; but see Rahman et al. 1994; Kishioka et al. 2000), an attempt to synthesize the findings of acute dependence and acute tolerance studies falls beyond the scope of this review. In addition, although withdrawal also occurs following a single exposure to benzodiazepines (Bronson 1994) or alcohol (Morse et al. 2000), this review focuses solely on acute opioid dependence, which has been studied most extensively.

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Acknowledgements

This work was supported by the National Institute of Drug Abuse T32 DA 07097 and the University of Minnesota.

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  1. Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN, 55455, USA

    Andrew C. Harris & Jonathan C. Gewirtz

  2. Department of Neuroscience, University of Minnesota, 321 Church Street, Minneapolis, MN, 55455, USA

    Jonathan C. Gewirtz

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Correspondence to Jonathan C. Gewirtz.

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Harris, A.C., Gewirtz, J.C. Acute opioid dependence: characterizing the early adaptations underlying drug withdrawal. Psychopharmacology 178, 353–366 (2005). https://doi.org/10.1007/s00213-005-2155-0

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Keywords

  • Morphine
  • Negative affect
  • Addiction
  • Escalation
  • Repeated withdrawals
  • Abstinence syndrome