Topical cannabinoid enhances topical morphine antinociception

Pain. 2003 Sep;105(1-2):303-8. doi: 10.1016/s0304-3959(03)00245-8.


Opioids and cannabinoids produce antinociception through both spinal and supraspinal action. Both opioids and cannabinoids also have important peripheral action. Many previous studies indicate that systemically administered cannabinoids enhance antinociceptive properties of opioids. Experiments were conducted to test the hypothesis that topical cannabinoids would enhance the topical antinociceptive effects of morphine. Antinociception was measured in the radiant tail-flick test after immersion of the tail of mice into a solution of dimethyl sulfoxide (DMSO) containing WIN 55, 212-2, a cannabinoid agonist and morphine, an opioid agonist. Morphine and WIN 55, 212-2 produce time dependent topical analgesic effects limited to the portion of the tail exposed to drugs. WIN 55, 212-2 had a potency lower than that of morphine. The topical antinociceptive effects of WIN 55, 212-2 were blocked by systemic pretreatment of cannabinoid CB1 receptor selective antagonist, AM 251. This suggests that topical antinociceptive effects of WIN 55, 212-2 involve CB1 receptors. Combination of topical WIN 55, 212-2 with topical morphine yielded significantly greater analgesic effects than that of topical morphine alone. The ability of the CB1 receptor antagonist AM 251 to antagonize the enhancement of antinociception of morphine by WIN 55, 212-2 indicates that WIN 55, 212-2 acts through a CB1 receptor to enhance the potency of topical morphine. Additionally, spinally administered ineffective doses of WIN 55, 212-2 potentiated the antinociceptive effects of topical morphine. These results demonstrate an antinociceptive interaction between topical opioids with topical, and spinal cannabinoids. These observations are significant in using of topical combination of cannabinoid and morphine in the management of pain.

MeSH terms

  • Administration, Topical
  • Analgesics / administration & dosage*
  • Analgesics, Opioid / administration & dosage*
  • Animals
  • Benzoxazines
  • Cannabinoids / administration & dosage
  • Dose-Response Relationship, Drug
  • Female
  • Hot Temperature
  • Mice
  • Mice, Inbred BALB C
  • Morphine / administration & dosage*
  • Morpholines / administration & dosage*
  • Motor Activity / drug effects
  • Naphthalenes / administration & dosage*
  • Nociceptors / drug effects*
  • Pain / physiopathology
  • Pain Measurement


  • Analgesics
  • Analgesics, Opioid
  • Benzoxazines
  • Cannabinoids
  • Morpholines
  • Naphthalenes
  • (3R)-((2,3-dihydro-5-methyl-3-((4-morpholinyl)methyl)pyrrolo-(1,2,3-de)-1,4-benzoxazin-6-yl)(1-naphthalenyl))methanone
  • Morphine