Cannabinoid-opioid interactions during neuropathic pain and analgesia

Curr Opin Pharmacol. 2010 Feb;10(1):80-6. doi: 10.1016/j.coph.2009.09.009. Epub 2009 Oct 25.


Opiates and exogenous cannabinoids, both potent analgesics used for the treatment of patients with neuropathic pain, bind to and activate class A G-protein-coupled receptors (GPCRs). Several lines of evidence have recently suggested that opioid and cannabinoid receptors can functionally interact in the central nervous system (CNS). These interactions may be direct, such as through receptor heteromerization, or indirect, such as through signaling cross-talk that includes agonist-mediated release and/or synthesis of endogenous ligands that can activate downstream receptors. Interactions between opioid and cannabinoid receptors may mediate many of the behavioral phenomena associated with the use of these drugs, including the production of acute antinociception and the development of tolerance and cross-tolerance to the antinociceptive effects of opioid and cannabinoid-specific ligands. This review summarizes behavioral, anatomical, and molecular data characterizing these interactions during the development of neuropathic pain and during antinociceptive treatment with these drugs alone or in combination. These studies are critical for understanding how the receptor systems involved in pain relief are altered during acute or chronic pain, and for designing better antinociceptive drug therapies, such as the combined use of opioid and cannabinoid receptor agonists or selective activation of receptor heteromers, that directly target the altered neurophysiology of patients experiencing pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Analgesics, Opioid / pharmacology*
  • Animals
  • Cannabinoid Receptor Agonists*
  • Cannabinoids / pharmacology*
  • Central Nervous System / drug effects
  • Central Nervous System / metabolism
  • Drug Delivery Systems
  • Drug Therapy, Combination
  • Drug Tolerance
  • Humans
  • Neuralgia / drug therapy
  • Neuralgia / physiopathology
  • Pain / drug therapy
  • Pain / physiopathology
  • Receptors, Cannabinoid / metabolism
  • Receptors, Opioid / agonists*
  • Receptors, Opioid / metabolism


  • Analgesics, Opioid
  • Cannabinoid Receptor Agonists
  • Cannabinoids
  • Receptors, Cannabinoid
  • Receptors, Opioid