The effects of agonist opioids on the psychopathology of opioid dependence

Knowledge about the beneficial psychotropic effects of opiates dates back to the pre-pharmacological era, but the use of opiates has been restricted because of the controversial issue of their liability to abuse, and the potentially lethal effects of accidental or voluntary overdosing. We first review the literature on opiate use and its impact on depressive, anxious, manic and psychotic syndromes, mostly by referring to studies selected from the field of addiction treatment. We then go on to discuss the differences between methadone and buprenorphine in their impact on the psychopathological profiles of heroin addicts. The data gathered by us support the view that some opiates may be regarded as therapeutic not only in the treatment of addictive diseases, but also as candidates for the treatment of certain psychiatric disorders. Such properties are based on their specific activity on opiate receptors, but also on their kinetics, which explain the differences between a destabilizing drug of abuse and a therapeutic agent.