# Opioid Receptors in Psychedelia: Indirect Serotonergic Modulation of Direct KOR Activation by Salvinorin A

**Authors:** Maximiliano Ganado, Carmen Rubio, Javier Pérez-Villavicencio, Norma Serrano, Héctor Romo-Parra, Ángel Lee, Moisés Rubio-Osornio

PMC · DOI: 10.3390/biomedicines14020476 · Biomedicines · 2026-02-21

## TL;DR

This paper explores how salvinorin A, a non-classical psychedelic, alters consciousness through kappa opioid receptors, offering new insights into psychedelic mechanisms beyond serotonin.

## Contribution

The paper introduces a framework for understanding non-serotonergic psychedelic effects, emphasizing salvinorin A's unique KOR activation and its therapeutic potential.

## Key findings

- Salvinorin A activates KORs with β-arrestin-biased signaling, causing rapid desensitization and dissociative effects.
- Classical psychedelics indirectly influence opioid systems via 5-HT2A signaling, affecting mood and pain regulation.
- Salvinorin A has low abuse potential due to aversive effects and lack of positive reinforcement in animal models.

## Abstract

The neuropharmacology of psychedelics has traditionally focused on serotonergic mechanisms, particularly 5-HT2A receptor activation. However, this paradigm incompletely explains the diversity of neurobiological and therapeutic effects observed across psychedelic compounds. Non-classical psychedelics such as salvinorin A, the primary active constituent of Salvia divinorum, challenge this framework through direct kappa opioid receptor (KOR) agonism, representing a serotonin-independent pathway to altered consciousness. This review systematically examines the role of the endogenous opioid system in mediating psychedelic effects, with emphasis on salvinorin A’s unique KOR-dependent mechanisms. We synthesized preclinical and clinical evidence from in vitro studies, genetically modified animal models, optogenetic circuit dissection, and human neuroimaging trials. Salvinorin A’s selective KOR activation is characterized by pronounced β-arrestin-biased signaling, distinguishing it from endogenous dynorphins and classical KOR agonists. This produces rapid receptor desensitization, transient functional plasticity, and profound dissociative effects mediated through thalamocortical disruption, mesolimbic dopaminergic suppression, and fragmentation of large-scale brain networks. Classical serotonergic psychedelics indirectly engage opioid systems through downstream 5-HT2A signaling, contributing to analgesic and mood-regulatory effects via secondary MOR/DOR modulation. Despite being a potent opioid agonist, salvinorin A exhibits low abuse potential due to aversive phenomenology, dopaminergic suppression, and absence of positive reinforcement in animal models. Incorporating opioid receptor pharmacology into psychedelic neuroscience expands mechanistic understanding beyond serotonin-centric models, revealing multiple neurochemical pathways capable of inducing therapeutically relevant altered states. This framework enables rational development of biased KOR ligands and establishes salvinorin A as a paradigmatic model for non-serotonergic psychedelia with applications in treatment-resistant depression, addiction, and chronic pain.

## Linked entities

- **Proteins:** HTR2A (5-hydroxytryptamine receptor 2A), OPRK1 (opioid receptor kappa 1), OPRM1 (opioid receptor mu 1), OPRD1 (opioid receptor delta 1)
- **Chemicals:** salvinorin A (PubChem CID 128563), dynorphins (PubChem CID 16129685)
- **Species:** Salvia divinorum (taxon 28513)

## Full-text entities

- **Genes:** Pomc (pro-opiomelanocortin-alpha) [NCBI Gene 18976] {aka ACTH, BE, Beta-LPH, Clip, Gamma-LPH, Npp}, Slc6a3 (solute carrier family 6 (neurotransmitter transporter, dopamine), member 3) [NCBI Gene 13162] {aka DAT, Dat1}, Creb1 (cAMP responsive element binding protein 1) [NCBI Gene 12912] {aka 2310001E10Rik, 3526402H21Rik, Creb, Creb-1}, OPRK1 (opioid receptor kappa 1) [NCBI Gene 4986] {aka K-OR-1, KOP, KOR, KOR-1, KOR1, OPRK}, Gpbar1 (G protein-coupled bile acid receptor 1) [NCBI Gene 227289] {aka BG37, GPCR, GPR131, M-BAR, TGR5}, Grk4 (G protein-coupled receptor kinase 4) [NCBI Gene 14772] {aka A830025H08Rik, GRK, Gprk2l, Gprk4}, Oprm1 (opioid receptor, mu 1) [NCBI Gene 18390] {aka M-OR-1, MOP-R, MOR-1, MOR-1O, Oprm, mor}, HTR2A (5-hydroxytryptamine receptor 2A) [NCBI Gene 3356] {aka 5-HT2A, HTR2}, Oprk1 (opioid receptor, kappa 1) [NCBI Gene 18387] {aka K-OR-1, KOR, KOR-1, MSL-1, Oprk2, R21}, Gpr34 (G protein-coupled receptor 34) [NCBI Gene 23890] {aka Lypsr1}, Arc (activity regulated cytoskeletal-associated protein) [NCBI Gene 11838] {aka Arc3.1, arg3.1, mArc}, Grk2 (G protein-coupled receptor kinase 2) [NCBI Gene 110355] {aka Adrbk-1, Adrbk1, Bark-1, beta ARK, betaARK1}, OPRM1 (opioid receptor mu 1) [NCBI Gene 4988] {aka LMOR, M-OR-1, MOP, MOR, MOR1, OPRM}, Htr2a (5-hydroxytryptamine (serotonin) receptor 2A) [NCBI Gene 15558] {aka 5-HT-2, 5-HT-2A, E030013E04, Htr-2, Htr2}, TP53INP2 (tumor protein p53 inducible nuclear protein 2) [NCBI Gene 58476] {aka C20orf110, DOR, PINH, dJ1181N3.1}, Bdnf (brain derived neurotrophic factor) [NCBI Gene 12064], Fos (Fos proto-oncogene, AP-1 transcription factor subunit) [NCBI Gene 14281] {aka D12Rfj1, c-fos, cFos}, Ntrk2 (neurotrophic tyrosine kinase, receptor, type 2) [NCBI Gene 18212] {aka GP145-TrkB/GP95-TrkB, Tkrb, trk-B, trkB}, Th (tyrosine hydroxylase) [NCBI Gene 21823], Hspg2 (perlecan (heparan sulfate proteoglycan 2)) [NCBI Gene 15530] {aka HSPG, Pcn, Plc, per}, Mtor (mechanistic target of rapamycin kinase) [NCBI Gene 56717] {aka 2610315D21Rik, FRAP, FRAP2, Frap1, RAFT1, RAPT1}, Mapk8 (mitogen-activated protein kinase 8) [NCBI Gene 26419] {aka JNK, JNK1, Prkm8, SAPK1}, Mapk14 (mitogen-activated protein kinase 14) [NCBI Gene 26416] {aka CSBP2, Crk1, Csbp1, Mxi2, PRKM14, PRKM15}, Oprd1 (opioid receptor, delta 1) [NCBI Gene 18386] {aka DOR, DOR-1, Nbor, mDOR}
- **Diseases:** QT interval prolongation (MESH:D008133), torsades de pointes (MESH:D016171), neuropathic (MESH:D009437), Depression (MESH:D003866), Chronic Pain (MESH:D059350), dysphoric dissociation (MESH:C565864), cardiac disease (MESH:D006331), neuropsychiatric (MESH:C000631768), opioid withdrawal (MESH:D013375), altered consciousness (MESH:D003244), terminal illness (MESH:D007153), cardiac toxicity (MESH:D066126), major depressive disorder (MESH:D003865), opioid dependence (MESH:D009293), PTSD (MESH:D013313), analgesia (MESH:D000699), visceral pain (MESH:D059265), respiratory depression (MESH:D012131), stress-related disorders (MESH:D000068099), Mood Disorders (MESH:D019964), ventricular arrhythmias (MESH:D001145), psychiatric (MESH:D001523), Substance Use Disorders (MESH:D019966), dysphoria (MESH:D019052), neuroinflammatory (MESH:D000090862), anxiety (MESH:D001007), injury to (MESH:D014947), inflammation (MESH:D007249), pain (MESH:D010146), anhedonia (MESH:D059445), addictive behaviors (MESH:D000437)
- **Chemicals:** Dopaminergic (MESH:D004298), morphine (MESH:D009020), alcohol (MESH:D000438), Ibogaine (MESH:D007050), DAG (MESH:D004075), 5-HT (MESH:D012701), diterpene (MESH:D004224), indole (MESH:C030374), psilocybin (MESH:D011562), calcium (MESH:D002118), triazoles (MESH:D014230), salvinorin B (MESH:C508456), LSD (MESH:D008238), 3,4-methylenedioxymethamphetamine (MESH:D018817), Ca2+) channels (-), MK-801 (MESH:D016291), DMT (MESH:D004130), Tryptamines (MESH:D014363), GABA (MESH:D005680), phenylethylamine (MESH:D010627), Sal A (MESH:C090499), NMDA (MESH:D016202), indole alkaloid (MESH:D026121), glutamate (MESH:D018698), DOI (MESH:C015952), ergoline (MESH:D004873), cAMP (MESH:D000242), IP3 (MESH:D015544), ethylamine (MESH:C041564), fentanyl (MESH:D005283), Mescaline (MESH:D008635), 12-hydroxyibogamine (MESH:C094385), nitrogen (MESH:D009584), 5-methoxy-N,N-dimethyltryptamine (MESH:D008732), nor-BNI (MESH:C051844), psilocin (MESH:C009105)
- **Species:** Rattus norvegicus (brown rat, species) [taxon 10116], Rodentia (rodent, order) [taxon 9989], Homo sapiens (human, species) [taxon 9606], Tabernanthe iboga (species) [taxon 141617], Nicotiana tabacum (American tobacco, species) [taxon 4097], Mus musculus (house mouse, species) [taxon 10090], Salvia divinorum (diviner's sage, species) [taxon 28513]

## Full text

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## Figures

10 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12938729/full.md

## References

142 references — full list in the complete paper: https://tomesphere.com/paper/PMC12938729/full.md

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Source: https://tomesphere.com/paper/PMC12938729