Seeking new methods to treat heroin addiction

September 26, 2013 by Elin Fugelsnes

"Heroin itself is an inactive substance," explains Jørg Mørland, Norwegian forensic medicine and toxicology researcher. "The substances that heroin forms in the body are mainly what enter the brain and cause the narcotic effects."

The heroin high and feelings of manifest themselves almost immediately after the drug has been injected. Yet it was shown many years ago that heroin is inactive at the in the .

So what is it about heroin that brings about such a pronounced effect? A number of research projects funded under the Programme on Alcohol and Drug Research (RUSMIDDEL) at the Research Council of Norway may help to solve the mystery.

"Gaining a thorough understanding of the effects of heroin and of the involved will be a valuable basis for the development of new treatments for addiction," states Jørg Mørland, who is the project manager of an ongoing project on this important subject, the most recent in a long line of such Norwegian projects which he has headed.

Dr Mørland is a senior researcher at the Norwegian Institute of Public Health and Professor emeritus at the University of Oslo. Through studies on and mice, he and his colleagues have come up with new findings that may be significant to the development of new treatment methods.

Heroin metabolises rapidly

One widely-held theory has been that heroin passes quickly into the brain where it is converted into morphine, and that what users are actually experiencing are the effects of morphine. As it turns out, however, heroin undergoes a number of important transformations on its way to the brain. Just a few minutes after injection, the conversion of heroin into the metabolite 6-MAM is almost complete.

"Our research shows that it is primarily 6-MAM that crosses the blood-brain barrier and that heroin as such only enters the brain to a small degree. Thirty minutes after injecting heroin, 6-MAM is the predominant substance both in the blood and in the brain," Dr Mørland explains.

The presence of 6-MAM also results in a sharp increase in the signalling molecule, dopamine, in certain areas of the brain. This plays a pivotal role in the rewarding effect.

"This points towards 6-MAM as the main substance behind all the acute effects of heroin," says Dr Mørland.

"After about an hour, most of the 6-MAM has been converted into morphine. Morphine acts rapidly on the body and is the dominant component for the next hours, but from six to twelve hours after injection the effects observed are mostly consequences of a formed from , morphin-6-glucuronide.

Looking for a new treatment

"We are working to understand the roles of all these metabolites and to investigate potential treatments to counter their effects," Dr Mørland states.

The current approach to treating heroin addiction in Norway is pharmacotherapy – using methadone, subutex or subuxone. These are synthetic substances that all work in the same way as heroin, however, and are addictive in their own right.

"The treatment method involves administering these substances over the course of a day to reduce the rewarding effect. The intent is to diminish the patient's preoccupation with finding heroin in order to lead a more normal life," Dr Mørland points out.

Researchers at the Norwegian Centre for Addiction Research (SERAF) in Oslo are examining sustained-release naltrexone – a non-addictive opioid antagonist that blocks the effects of opiates in the brain. Dr Mørland is hopeful that his research will make it possible to affect opiates even before they reach the brain.

An opiate roadblock

"It may be possible to block these substances from ever entering the brain, thereby modifying the effect of heroin," Dr Mørland adds.

As part of a new project, he and his colleagues will study the effect of a 6-MAM antibody developed by a Norwegian company. The antibody binds to the 6-MAM in the blood, making the 6-MAM molecule too large to cross the blood-brain barrier.

"If we succeed in getting this antibody to work it could block much – and maybe even all – of the effect of ," the concludes.

Explore further: Abuse of painkillers raises risk of heroin use, study finds

Related Stories

Abuse of painkillers raises risk of heroin use, study finds

August 22, 2013
(HealthDay)—Illegal use of prescription pain drugs increases a person's risk of becoming a heroin user, a U.S. government report suggests.

Heroin vaccine blocks relapse in preclinical study

May 6, 2013
Scientists at The Scripps Research Institute (TSRI) have reported successful preclinical tests of a new vaccine against heroin. The vaccine targets heroin and its psychoactive breakdown products in the bloodstream, preventing ...

Long-term methadone treatment can affect nerve cells in brain

August 15, 2012
Long-term methadone treatment can cause changes in the brain, according to recent studies from the Norwegian Institute of Public Health. The results show that treatment may affect the nerve cells in the brain. The studies ...

Scientists can now block heroin, morphine addiction; clinical trials possible within 18 months

August 14, 2012
In a major breakthrough, an international team of scientists has proven that addiction to morphine and heroin can be blocked, while at the same time increasing pain relief.

Scientists create vaccine against heroin high

July 20, 2011
Researchers at The Scripps Research Institute have developed a highly successful vaccine against a heroin high and have proven its therapeutic potential in animal models.

Recommended for you

Marijuana use may not aid patients in opioid addiction treatment

December 4, 2017
Many patients who are being treated for opioid addiction in a medication-assisted treatment clinic use marijuana to help manage their pain and mood symptoms.

For opiate addiction, study finds drug-assisted treatment is more effective than detox

November 23, 2017
Say you're a publicly insured Californian with an addiction to heroin, fentanyl or prescription narcotics, and you want to quit.

Study finds medical cannabis is effective at reducing opioid addiction

November 17, 2017
A new study conducted by researchers at The University of New Mexico, involving medical cannabis and prescription opioid use among chronic pain patients, found a distinct connection between having the legal ability to use ...

Insomnia linked to alcohol-use frequency among early adolescents, says new psychology study

November 8, 2017
Insomnia is linked to frequency of alcohol use among early adolescents, according to new Rutgers University–Camden research.

Large declines seen in teen substance abuse, delinquency

October 25, 2017
More than a decade of data indicates teens have become far less likely to abuse alcohol, nicotine and illicit drugs, and they also are less likely to engage in delinquent behaviors, such as fighting and stealing, according ...

Trying to get sober? NIH offers tool to help find good care

October 3, 2017
The phone calls come—from fellow scientists and desperate strangers—with a single question for the alcohol chief at the National Institutes of Health: Where can my loved one find good care to get sober?


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.