Psychotherapeutic Benefits of Opioid Agonist Therapy

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Opioids have been used for centuries to treat a variety of psychiatric conditions with much success. The so-called opium cure lost popularity in the early 1950s with the development of non-addictive tricyclic antidepressants and monoamine oxidase inhibitors. Nonetheless, recent literature supports the potent role of methadone, buprenorphine, tramadol, morphine, and other opioids as effective, durable, and rapid therapeutic agents for anxiety and depression. This article reviews the medical literature on the treatment of psychiatric disorders with opioids (notably, methadone and buprenorphine) in both the non-opioid-dependent population and in the opioid-dependent methadone maintenance population. The most recent neurotransmitter theories on the origin of depression and anxiety will be reviewed, including current information on the role of serotonin, N-Methyl d-Aspartate, glutamate, cortisol, catecholamine, and dopamine in psychiatric disorders. The observation that methadone maintenance patients with co-existing psychiatric morbidity (so called dual diagnosis patients) require substantially higher methadone dosages by between 20% and 50% will be explored and qualified. The role of methadone and other opioids as beneficial psychiatric medications that are independent of their drug abuse mitigating properties will be discussed. The mechanisms by which methadone and other opioids can favorably modulate the neurotransmitter systems controlling mood will also be discussed.

Original languageEnglish (US)
Pages (from-to)49-65
Number of pages17
JournalJournal of Addictive Diseases
Volume27
Issue number3
DOIs
StatePublished - Jun 12 2008

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Methadone
Opioid Analgesics
Psychiatry
Buprenorphine
Therapeutics
Neurotransmitter Agents
Anxiety
Dual (Psychiatry) Diagnosis
Depression
Opium
Tramadol
Monoamine Oxidase Inhibitors
Tricyclic Antidepressive Agents
Aspartic Acid
Morphine
Population
Substance-Related Disorders
Catecholamines
Hydrocortisone
Glutamic Acid

Keywords

  • Anxiety
  • Co-morbidity
  • Depression
  • Methadone
  • Opioid
  • Psychiatric

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Psychotherapeutic Benefits of Opioid Agonist Therapy. / Tenore, Peter L.

In: Journal of Addictive Diseases, Vol. 27, No. 3, 12.06.2008, p. 49-65.

Research output: Contribution to journalArticle

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