Cue-induced reactivity, cortisol response and substance use outcome in treated heroin dependent individuals
Biological Psychiatry. 2011-10-01; 70(8): 720-727
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1. Biol Psychiatry. 2011 Oct 15;70(8):720-7. doi: 10.1016/j.biopsych.2011.05.015.
Epub 2011 Jul 8.
Cue-induced reactivity, cortisol response and substance use outcome in treated
heroin dependent individuals.
Fatseas M(1), Denis C, Massida Z, Verger M, Franques-Rénéric P, Auriacombe M.
(1)Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche
Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen,
BACKGROUND: Environmental stimuli associated with drug taking have been known to
elicit drug craving and physiologic arousal, as well as
hypothalamic-pituitary-adrenal axis activation. However, the relationship between
these responses and substance use outcomes in heroin-dependent subjects has not
been previously studied. We investigated the relationship among subjective and
physiologic reactivity, biological stress response evoked in the laboratory, and
relapse to substance use in treated opiate-dependent individuals.
METHODS: Eighteen opiate-abstinent methadone- or buprenorphine-treated patients
and 13 control subjects were exposed to neutral- and drug-cue exposure laboratory
sessions with a 3-month follow-up period. Exposure to cues involved both
videotapes and handling during a 100-min session. Subjective craving, agonistic
effects, withdrawal feelings, galvanic skin resistance, and salivary cortisol
were assessed. Substance use outcome among patients was examined during the
follow-up phase. Differences between relapsers, nonrelapsers, and controls were
analyzed with respect to the data on drug-cue responsivity and on cortisol
responses using repeated-measures analysis of variance. The association with
substance use outcome was assessed using a nominal logistic model.
RESULTS: Relapsers experienced greater drug-cue induced subjective responses and
an increased cortisol response compared with both nonrelapsers and control
subjects. After adjusting on covariates, cue-induced cortisol response was
associated with the relapser group and was highly correlated with self-reports of
« high. »
CONCLUSIONS: Subjects defined as relapsers presented a higher cue-induced
reactivity during the drug-cue exposure as well as an increased cortisol response
to drug cues. Higher cortisol response to drug cues may increase relapse
vulnerability in stable-dose buprenorphine or methadone-maintained subjects.
Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All
PMID: 21741031 [Indexed for MEDLINE]