Theories of Tolerance to and Physical Dependence on Opioids

  • Abraham Wikler


Though under certain conditions (see below), tolerance to opioids can develop without concomitant physical dependence, the two phenomena will be considered together inasmuch as most explanatory theories postulate common mechanisms and assume that one sort or another of “counteradaptation” to the agonistic actions of opioids develops during repeated drug administration (accounting for tolerance); this results in “latent hyperexcitability” of the central nervous system, which is suppressed as long as opioids are administered; when opioids are abruptly withdrawn, or when a narcotic antagonist is administered, the latent hyperexcitability becomes manifest as the opioid-abstinence syndrome (indicative of physical dependence).


Physical Dependence Morphine Withdrawal Morphine Injection Morphine Tolerance Cold Plate 
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© Plenum Press, New York 1980

Authors and Affiliations

  • Abraham Wikler
    • 1
  1. 1.Department of PsychiatryUniversity of Kentucky Medical CenterLexingtonUSA

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