Heroin Cravings Reduced by Stress Hormone

Every addiction is characterized by a strong desire for a certain addictive substance, be it nicotine, alcohol or other drug. Researchers at the University of Basel in Switzerland recently conducted a study on heroin addiction and demonstrated that the stress hormone cortisol can reduce addictive cravings. The findings from the research have been published in the medical journal Translational Psychiatry.

Heroin is a drug with an extremely high dependency potential that stimulates severe cravings in addicts. A team of researchers led by PD Dr. Marc Walter and Prof. Dominique de Quervain from the University of Basel recently studied the effect of the stress hormone cortisol on the addictive cravings in heroin addicts.

In past studies, the researchers in Basel discovered that cortisol diminishes the ability to retrieve memories; intake of the hormone reduced the brain’s ability to remember. This can be used, for example, to relieve symptoms in patients suffering from anxiety disorders by inhibiting the patients’ ability to recall anxious episodes. The researchers hypothesized that cortisol also has an inhibitory effect on addiction-related memory and thus on the craving for the addictive substance.

Addiction-related memory diminished

In this study, 29 patients currently undergoing heroin-assisted treatment were given a cortisol tablet or placebo before receiving a dose of heroin. Administering cortisol to the addicts resulted in a decrease in cravings by an average of 25% when compared to placebo. Along with other tests, the subjects were asked to rate their cravings on a visual analogue scale (VAS), which is a scale for gauging subjective experiences. This decrease was seen in patients who were dependent on a relatively low dose of heroin but not in highly-dependent patients.

This image shows a 3d molecular structure diagram of cortisol.

The researchers hypothesized that cortisol has an inhibitory effect on addiction-related memory and thus on the craving for the addictive substance. Image is for illustrative purposes only.

Whether the inhibitory effect of cortisol on the craving for heroin will also affect addiction-related behaviors of patients in their day-to-day lives is still unclear. “For this reason, we want to examine whether cortisol can help patients reduce their heroin dosage or remain abstinent from heroin for longer,” says Marc Walter, chief physician at the Psychiatric University Clinics (UPK) Basel.

Plans are already underway for further studies. The goal is to determine whether “the inhibitory effect of cortisol on addictive cravings might also have positive implications for nicotine, alcohol or gambling addiction,” says Dominique de Quervain, Director of the research platform Molecular and Cognitive Neurosciences at the University of Basel.

About this addiction research

Source: Reto Caluori – University of Basel
Image Credit: The image is in the public domain
Original Research: Full open access research for “Effects of cortisol administration on craving in heroin addicts” by M Walter, D Bentz, N Schicktanz, A Milnik, A Aerni, C Gerhards, K Schwegler, M Vogel, J Blum, O Schmid, B Roozendaal, U E Lang, S Borgwardt and D de Quervain in Translational Psychiatry. Published online July 28 2015 doi:10.1038/tp.2015.101


Abstract

Effects of cortisol administration on craving in heroin addicts

Heroin dependence is a severe and chronically relapsing substance use disorder with limited treatment options. Stress is known to increase craving and drug-taking behavior, but it is not known whether the stress hormone cortisol mediates these stress effects or whether cortisol may rather reduce craving, for example, by interfering with addiction memory. The aim of the present study was to determine the effects of cortisol administration on craving in heroin-dependent patients and to determine whether the effects depend on the daily dose of heroin consumption. We used a double-blind, placebo-controlled, cross-over study in 29 heroin-dependent patients in a stable heroin-assisted treatment setting. A single oral dose of 20 mg of cortisol or placebo was administered 105 min before the daily heroin administration. The primary outcome measure was cortisol-induced change in craving. Secondary measures included anxiety, anger and withdrawal symptoms. For the visual analog scale for craving, we found a significant interaction (P=0.0027) between study medication and heroin-dose group (that is, daily low, medium or high dose of heroin). Cortisol administration reduced craving in patients receiving a low dose of heroin (before heroin administration: P=0.0019; after heroin administration: P=0.0074), but not in patients receiving a medium or high dose of heroin. In a picture-rating task with drug-related pictures, cortisol administration did not affect the ratings for the picture-characteristic craving in all the three heroin-dose groups. Cortisol also did not significantly affect secondary outcome measures. In conclusion, a single administration of cortisol leads to reduced craving in low-dose heroin addicts. The present findings might have important clinical implications with regard to understanding stress effects and regarding treatment of addiction.

“Effects of cortisol administration on craving in heroin addicts” by M Walter, D Bentz, N Schicktanz, A Milnik, A Aerni, C Gerhards, K Schwegler, M Vogel, J Blum, O Schmid, B Roozendaal, U E Lang, S Borgwardt and D de Quervain in Translational Psychiatry. Published online July 28 2015 doi:10.1038/tp.2015.101

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