Nicotine and opioid co-dependence: Findings from bench research to clinical trials

• Published in: Neuroscience and biobehavioral reviews 2022-03, Vol.134, p.104507-104507, Article 104507
• Main Authors: Custodio, Lilian, Malone, Samantha, Bardo, Michael T., Turner, Jill R.
• Format: Article
• Language: English
• Subjects: Analgesics, Opioid - pharmacology; Analgesics, Opioid - therapeutic use; Clinical trials; Genetics; Humans; Neurobiology of addiction; Nicotine; Nicotine - pharmacology; Nicotine - therapeutic use; Opioid-Related Disorders - drug therapy; Opioids; Polydrug abuse; Receptors, Nicotinic - therapeutic use; Rodent models; Substance use disorder; Tobacco Use Disorder - drug therapy
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2021.12.030

•This comprehensive review outlines the current evidence from rodent and human investigations on integrative nicotine and opioid research.•We characterize behavioral, neural, and genetic mechanisms that underlie nicotine and opioid co-dependence and then delineate clinical trials addressing this co-morbidity.•The effectiveness of pharmacotherapy and multimodal interventions for smoking cessation in opioid-dependent smokers is discussed.•We evaluate gaps in the literature, examining methodological discrepancies among studies and areas for future investigations. Concomitant use of tobacco and opioids represents a growing public health concern. In fact, the mortality rate due to smoking-related illness approaches 50% among SUD patients. Cumulative evidence demonstrates that the vulnerability to drugs of abuse is influenced by behavioral, environmental, and genetic factors. This review explores the contribution of genetics and neural mechanisms influencing nicotine and opioid reward, respiration, and antinociception, emphasizing the interaction of cholinergic and opioid receptor systems. Despite the substantial evidence demonstrating nicotine-opioid interactions within the brain and on behavior, the currently available pharmacotherapies targeting these systems have shown limited efficacy for smoking cessation on opioid-maintained smokers. Thus, further studies designed to identify novel targets modulating both nicotinic and opioid receptor systems may lead to more efficacious approaches for co-morbid nicotine dependence and opioid use disorder.