Molecular and cellular basis of cannabinoid and opioid interactions.

Cannabinoids and opioids have been shown to possess several similar pharmacological effects, including analgesia and stimulation of brain circuitry that are believed to underlie drug addiction and reward. In recent years, these phenomena have supported the possible existence of functional links in the mechanisms of action of both types of drugs. The present review addresses the recent advances in the study of biochemical and molecular mechanisms underlying opioid and cannabinoid interaction. Several hypothesis have been formulated to explain this cross-modulation including the release of opioid peptides by cannabinoids or endocannabinoids by opioids and interaction at the level of receptor and/or their signal transduction mechanisms. Moreover it is important to consider that the nature of cannabinoid and opioid interaction might differ in the brain circuits mediating reward and in those mediating other pharmacological properties, such as antinociception. While in vitro studies point to the presence of interaction at various steps along the signal transduction pathway, studies in intact animals are frequently contradictory pending on the used species and the adopted protocol. The presence of reciprocal alteration in receptor density and efficiency as well as the modification in opioid/cannabinoid endogenous systems often do not reflect the behavioral results. Further studies are needed since a better knowledge of the opioid-cannabinoid interaction may lead to exciting therapeutic possibilities.