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tone
Veteran
Reged: 06/29/03
Posts: 531
Loc: Chicago
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Endogenous Opioids
"I'll die young, but it's like kissing God"
Lenny Bruce
We are all naturally dependent on opioids for our emotional health. Both narcotics and internally generated endorphins exert their action on the body by interacting with specific membrane receptor-proteins on our nerve cells.
The body produces three large pro-compounds: proenkephalin, prodynorphin, and pro-opiomelanocortin. Endorphins can further decompose to small fragments, oligomers, which are still active. Oligomers pass the blood-brain barrier more readily. Enzymatic degradation of small-chain endorphins is accomplished by dipeptidyl carboxypeptidase, enkephalinases, angiotensinases, and other enzymes. This limits their lifetime in the unbound state.
Opioid receptors presynaptically inhibit transmission of excitatory pathways. These pathways include acetylcholine, the catecholamines, serotonin, and substance P. Substance P is a neuropeptide active in neurons that mediate our sense of pain; antagonists of substance P are currently under investigation as clinical antidepressants. Endorphins are also involved in glucose regulation. Opioid receptors are functionally designated as mu, delta, kappa, etc. These categories can be further sub-classified by function or structure. Decoding the human genome has allowed the genetic switching-mechanisms that control the expression of each opioid receptor to be determined at the transcriptional and post-transcriptional level.
All classes of opioid receptor share key similarities. Activation of any type of opioid receptor inhibits adenylate cyclase. Also, opioid receptors all have a common general structure. They are typically G protein-linked receptors embedded in the plasma membrane of neurons. Once the receptors are bound, a portion of the G protein is activated, allowing it to diffuse within the plasma membrane. The G protein moves within the membrane until it reaches its target - either an enzyme or an ion channel. These targets normally alter protein phosphorylation and/or gene transcription. Whereas protein phosphorylation alters short-term neuronal activity, gene transcription acts over a longer timescale.
Two new classes of opioid neuropeptide have recently been identified. These are nociceptin and the endomorphins.
Nociceptin (also known as orphanin) was first identified in 1995. It is the endogenous ligand of the opioid receptor-like 1 receptor. Depending dosage and site, nociceptin has extremely nasty hyperalgesic effects, Nociceptin receptor antagonists are candidate antidepressants and analgesics.
Endomorphin1 and endomorphin2 are newly-discovered ligands with the highest affinity and selectivity for the mu opioid receptor of all the endogenous opioids. In the absence of selective endogenous mu-opioid receptor agonists, our pain and suffering would be even worse.
Opioidergic neurons are particularly concentrated in the ventral tegmental area. The VTA is an important nerve tract in the limbic system. The VTA passes messages to clusters of nerve cells in the nucleus accumbens and the frontal cortex. This forms the brain's primary reward pathway, the mesolimbic dopamine system. Its neurons are called dopaminergic because dopamine is manufactured, transported down the length of the neuron, and packaged for release into the synapses.
GABA normally plays a braking role on the dopaminergic cells. Opioids and endogenous opioid neurotransmitters activate the presynaptic opioid receptors on GABA neurons. This inhibits the release of GABA in the ventral tegmental area. Inhibiting GABA allows the dopaminergic neurons to fire more vigorously. The release of extra dopamine in the nucleus accumbens is intensely pleasurable.
Mu receptors are crucial to the rewarding and addictive properties of opioids. Government researchers and pharmaceutical companies are searching for powerful analgesics that won't make the user feel happy too. Mu-receptors are found mainly in the brainstem and the medial thalamus. There are two primary sub-types: mu-1 and mu-2. Stimulation of the mu-1 receptors is primarily responsible for the beautiful sense of euphoria, serenity and analgesia induced by a potent and selective mu opioid agonist. Receptor activation by mu opioid agonists increases cell firing in the ventral tegmental area. This triggers dopamine release in the nucleus accumbens by reducing GABA's tonic inhibitory control of the dopaminergic neurons. By contrast, at the height of the opioid withdrawal syndrome, typical firing rates and burst firings of VTA-nucleus accumbens neurons are reduced to around 30% of normal. The withdrawal syndrome can be quickly remedied by the administration of a potent mu agonist such as morphine. Care is needed: stimulation of the mu-2 opioid receptors helps modulate respiratory depression. For obvious reasons, this is potentially dangerous. The endogenous ligands for the mu opioid receptors have recently been discovered. They are endomorphin-1 (Tyr-Pro-Trp-Phe-NH2, EM-1) and endomorphin-2 (Tyr-Pro-Phe-Phe-NH2, EM-2).
Unfortunately, we still lack clinically available opioids specific to the mu-1 receptor. Their advent will be a tremendous boon to mental and physical health.
http://opioids.com/opiates.html
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Thinking about this, one has to wonder what happens to someone who has an endorphin dysfuction in their brain? There are drugs for serotonin and noradrenaline dysfuction which are called antidepressants, but serotonin and noradrenaline are surely not the only pathways that could be dysfuctional. There are many depressives who do not respond to medication and this is known as "treatment resistive depression" or "refactory depression"
Also if a Mu-1 Specific Opioid were discovered, CPP patients could have safer pain pills with less side effects, such as respiratory depression with higher doses. other side effects like slower bowel movements could be less. but the government would never allow this would they?
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yawkaw3
Pooh-Bah

Reged: 03/22/03
Posts: 1193
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It's an interesting topic you bring up- one that's been discussed many times on any internet messageboard that somehow related to opiates.
There was a study done on rats and their responses to opiates. They were given access to morphine as much as they wanted it. A minority took it once, apparently didn't like it, and never took it again. The majority took it occasionally, but never really developed any kind of dependence. An even smaller minority took it and kept taking it throughout the entire study.
Assuming rats have no psychological problems, it DOES suggest that we may have different levels of endorphins being produced. Thing is- harsh early childhood experiences in all animals are thought to result in some sort of change to the brain later on in life. If you, for example, deprive a baby rat of its mother through infancy, it will have higher levels of noradrenaline and other stress hormones.
But rats are not humans, and humans use opiates for a variety of reasons. Whether it's pure hedonism, an escape from the boredom of everyday life, a desire for the personality changes on opiates, a need to cover up the feelings from trauma, or chronic physical pain, the point is, the reasons for using opiates are varied.
So with all these different reasons for using opiates, it's unlikely everyone who takes opiates habitually produces less natural endorphins. I know that's not what you're saying, and your question specifically mentioned people with refractory depression. It's very possible a lack of endorphins is a cause of refractory depression in SOME cases.
But regardless of why you started taking opiates in the first place, if you take them habitually for their intoxicating effects, you will end up with an endorphin deficiency anyway. When you quit opiates after having been on them a long time and in high doses used for pleasure, there is a blah time period- you're not high, you're not normal, you're just in this kind of void. Boredom and depression are typical. No antidepressant will fix this, but an opiate will. So it does make sense that after using opiates, your brain has trouble making new endorphins and enkephalins for a while. It also makes sense that if you have felt this way your whole life, and you haven't responded to therapy or other psych meds, opiates in some form may be what you need.
One thing to note: If you're using opiates to cover up some sort of emotional pain, the very drug that is making life tolerable for you is preventing any chance of healing. You need to feel that pain and be in good therapy to make progress- it's not going to go away if you take drugs to forget about it. It may take a lifetime to find the therapist who makes the difference, it may still take a long time depending on the size of your emotional wound. A wound can take a long time to heal, you may even scratch it along the way and delay the process, but the time is going to pass anyway- it is worth fixing for your own sake.
-yawkaw
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lemongrass
Board Addict
Reged: 09/23/03
Posts: 361
Loc: IL
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Very interesting topic! And this, I believe, is why so many people self-medicate. It's because they are lacking in their own body chemistry somehow and opiates or the like help, if only temporarily. But I agree that it will never be resolved simply by supplying the opiate. One needs the proper therapy and medications. There are so many quacks out there though. I often wonder where these people get their degree. And then there are the trial and errors that people have to go through, trying all sorts of meds to find the right combo or one that is effective for their particular problem/deficiency. Lots of time and money!
I have a question. If rats have no emotions, then how come they can have uniquely different personalities and behaviors? And how is they can be raised as pets and be warm toward their owner and seek the love and attention of it's master? Just a thought I was pondering when I read that statement.
lemongrass
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tone
Veteran
Reged: 06/29/03
Posts: 531
Loc: Chicago
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Quote:
One thing to note: If you're using opiates to cover up some sort of emotional pain, the very drug that is making life tolerable for you is preventing any chance of healing. You need to feel that pain and be in good therapy to make progress- it's not going to go away if you take drugs to forget about it. It may take a lifetime to find the therapist who makes the difference, it may still take a long time depending on the size of your emotional wound. A wound can take a long time to heal, you may even scratch it along the way and delay the process, but the time is going to pass anyway- it is worth fixing for your own sake.
-yawkaw
i don't believe too many people use any drug to cover up emotional pain. there is no "covering up" of emotions. There is only trying to feel normal. Depression is a non-emotional non-thought related condition. It has absolutely nothing to do with thoughts or emotions. Its actually a pure consciousness-mind state thing. To give you an example, drowsyness/fitgue is not a thought or an emotion, it is pure mind-state/consciousness state that has nothing to do with what your thinking or emotionally feeling. Another example is "focused". Being focused or having broken concentration are both not emotions. they are again, conscious mind states you are in. Chronic Dysphoria, which for some reason known by the name "Depression", is not thought or emotion related. it is also a pure conscious state. for example, most of my life i could actually physically feel dysphoria in the back center of my head at various amounts depending on how bad the depression is. IT is also something of sensory perception and how you are associated with all your surroundings and how you precieve them, again not an emotion or thought related thing.
There are no emotional wounds involved in real endogenous depression. Unfourntuatly Therapy makes as much sense for endogenous dysphoric depression as it does for schizophrenia, physical pain, or liver cancer. many self help books are infact written by pseudo intellectual acedemics who have never experienced the strange an alien state of dysphoria in their lives. they don't seem to make any sense either. it is analogous of a doctor recommending you "pain management courses" for chronic pain.
anyway i just want to clearify the difference between dysphoria and some emotional issue. an emotional issue is one thing whereas dysphoria is a pure consciousness mind state/perceptual thing just like schizophrentics' hallucinations or autistics' state of withdrawlness is non emotional
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yawkaw3
Pooh-Bah

Reged: 03/22/03
Posts: 1193
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Maybe I wasn't clear in the first post- I think that some people do have refractory depression that could respond to opiates because of naturally low endorphin/enkephalin levels. Emotional pain (like childhood trauma) was an entirely separate issue I was addressing.
Lemongrass- that's why I said "assuming rats have no psychological problems" We don't know.
-yawkaw
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