“…However, the use of opioid analgesics is associated with severe limiting side effects including abuse liability, respiratory depression, constipation, and development of tolerance and dependence. − Therefore, considerable effort has been expended on the discovery of novel opioid analgesics that are as efficacious as the prototypic opioid analgesic morphine but possessing reduced side effects. Opioid drugs exert their analgesic effects through binding and activation of the three opioid receptor subtypes, namely, the μ opioid receptor (MOR), the δ opioid receptor (DOR), and the κ opioid receptor (KOR). , Several lines of evidence suggest that there are physical and/or functional interactions between these G-protein coupled receptors, and molecules that interact with multiple receptors may prove advantageous in the search for opioid ligands with diminished side effect profiles. − Considerable evidence from gene knockout/knockdown studies and studies using pharmacological probes suggests that activation of the MOR with simultaneous inhibition of the DOR leads to MOR-mediated analgesic activity with diminished development of tolerance, dependence, and potentially other side effects. ,− Based on these observations, we , and others ,− pursued the development of mixed function ligands possessing a MOR agonist/DOR antagonist profile of activity using peptidic, peptidomimetic, and nonpeptide opioid templates. Exemplary MOR agonist/DOR antagonist ligands evaluated in animal models are shown in Figure .…”