Laboratory-induced stress and craving among individuals with prescription opioid dependence.
Laboratory-induced stress and craving among individuals with prescription opioid dependence.
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DOI：
10.1016/j.drugalcdep.2015.08.019
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发表时间：
2015-10-01
影响因子：
4.2
通讯作者：
McCauley JL
中科院分区：
文献类型：
--
作者：
Back SE;Gros DF;Price M;LaRowe S;Flanagan J;Brady KT;Davis C;Jaconis M;McCauley JL
压力和条件性药物线索与药物滥用的开始、维持和复发有关。虽然压力和药物提示经常一起遇到，但很少有研究表明压力是否会增强对药物提示的反应。参与者（N = 75）为39名社区招募的目前处方阿片类药物（PO）依赖的个体和36名健康对照。参与者在医院过夜一晚，然后在第二天早上完成实验室测试。在实验室测试中，参与者被随机分配到压力任务（特里尔社会压力任务; TSST）或无压力条件下。在压力操作之后，所有参与者完成了PO线索范式。在压力和线索任务之前和之后，立即评估以下内容：主观（压力，渴望，愤怒，悲伤，快乐），生理（心率，血压，皮肤电反应）和神经内分泌反应（皮质醇和脱氢表雄酮）。与无压力组相比，TSST中的主观压力以及皮质醇、心率和血压显着较高，证明了压力任务的内部有效性。PO依赖的个人表现出显着更大的反应比对照组的压力任务。在PO参与者中，对药物提示任务的渴望显着增加。没有观察到应激×线索的相互作用。在这项研究中，观察到PO依赖个体的应激反应增强。然而，暴露于急性应激并没有增强对条件性药物线索的渴望。
Stress and conditioned drug cues have been implicated in the initiation, maintenance and relapse to substances of abuse. Although stress and drug cues are often encountered together, little research exists on whether stress potentiates the response to drug cues. Participants (N = 75) were 39 community recruited individuals with current prescription opioid (PO) dependence and 36 healthy controls. Participants stayed overnight in the hospital for one night and then completed laboratory testing the following morning. During laboratory testing, participants were randomly assigned to a stress task (Trier Social Stress Task; TSST) or a no-stress condition. Following the stress manipulation, all participants completed a PO cue paradigm. Immediately before and after the stress and cue tasks, the following were assessed: subjective (stress, craving, anger, sadness, happiness), physiological (heart rate, blood pressure, galvanic skin response), and neuroendocrine responses (cortisol and dehydroepiandrosterone). Internal validity of the stress task was demonstrated, as evidenced by significantly higher subjective stress, as well as cortisol, heart rate and blood pressure in the TSST compared to the no-stress group. Individuals with PO dependence evidenced significantly greater reactivity to the stress task than controls. Craving increased significantly in response to the drug cue task among PO participants. No stress × cue interaction was observed. In this study, heightened stress reactivity was observed among individuals with PO dependence. Exposure to acute stress, however, did not potentiate craving in response to conditioned drug cues.