Reactivity to laboratory stress provocation predicts relapse to cocaine
Reactivity to laboratory stress provocation predicts relapse to cocaine
复制标题
DOI：
10.1016/j.drugalcdep.2009.07.016
复制
发表时间：
2010-01-01
影响因子：
4.2
通讯作者：
Braly, Kathleen T.
中科院分区：
文献类型：
--
作者：
Back, Sudie E.;Hartwell, Karen;Braly, Kathleen T.
背景：可卡因依赖是一种慢性复发性疾病，其特征是戒断期和高复吸率。升高的压力水平已与可卡因复发，然而，这种关联的性质是不好理解的。方法：三个人类实验室的挑衅和可卡因复发的反应之间的关系进行了研究。参与者是53名可卡因依赖者，他们住院2天，在此期间，特里尔社会压力任务），药理学激发（即，施用1 μ g/kg促肾上腺皮质激素释放激素; CRH），并完成药物线索暴露范例。在基线和任务后的多个时间点评估促肾上腺皮质激素（ACTH）、皮质醇、心率和主观可卡因渴望和压力。参与者的可卡因使用监测约一个月后testing.Results：大多数（72.3%）的参与者在随访期间复发可卡因。在对CRH和药物线索暴露的反应中，主观渴望和压力的升高是随访期间可卡因使用的重要预测因素。在特里尔，衰减的神经内分泌反应是显着的预测可卡因use.Conclusions：研究结果提供了进一步的证据，实验室的范例预测复发的能力。观察到的应激反应和随后的可卡因使用之间的关联突出了这些发现的临床重要性。复发的预测因素可能会有所不同的基础上使用的激发类型。干预措施，旨在正常化的压力反应，如使用实验室的范例，可能证明是有用的复发预防。出版社：Elsevier爱尔兰Ltd.
Background: Cocaine dependence is a chronic relapsing disorder characterized by periods of abstinence and high rates of return to drug using behavior. Elevated levels of stress have been associated with relapse to cocaine; however, the nature of this association is not well understood.Methods: The relationship between reactivity to three human laboratory provocations and relapse to cocaine was investigated. Participants were 53 cocaine-dependent individuals who were admitted for a 2-day inpatient stay during which a psychosocial provocation (i.e., the Trier Social Stress Task), a pharmacological provocation (i.e., administration of 1 mu g/kg corticotrophin releasing hormone; CRH), and a drug cue exposure paradigm were completed. Adrenocortico-trophic hormone (ACTH), cortisol, heart rate, and subjective cocaine craving and stress were assessed at baseline and at multiple time points post-task. Participants' cocaine use was monitored for approximately I month following testing.Results: The majority (72.3%) of participants relapsed to cocaine during the follow-up period. in response to the CRH and drug cue exposure, elevated subjective craving and stress were significant predictors of cocaine use during follow-up. In response to the Trier, attenuated neuroendocrine responses were significant predictors of cocaine use.Conclusions: The findings provide further evidence of the ability of laboratory paradigms to predict relapse. The observed associations between stress reactivity and subsequent cocaine use highlight the clinical importance of the findings. Predictors of relapse may vary based on the type of provocation utilized. Interventions aimed at normalizing stress response, as measured using laboratory paradigms, may prove useful in relapse prevention. Published by Elsevier Ireland Ltd.