Laboratory-induced stress and craving among individuals with prescription opioid dependence. (1st October 2015)

• Record Type: Journal Article
• Authors: Back, Sudie E.; Gros, Daniel F.; Price, Matthew; LaRowe, Steve; Flanagan, Julianne; Brady, Kathleen T.; Davis, Charles; Jaconis, Maryanne; McCauley, Jenna L.
• Is Part Of: Drug and alcohol dependence. Volume 155(2015)
• Page Start: 60
• Page End: 67
• Publication Date: 2015-10-01
• Subjects: Stress -- Trier -- Cues -- Prescription opioids -- Opiates; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.08.019
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Stress and cues implicated in the initiation and maintenance of drug abuse. Participants completed stress or no-stress conditions and then drug cue paradigm. Heightened stress reactivity and craving observed in PO group compared to controls. Exposure to stress did not potentiate craving in response to drug cues. Stress response is not by enhancing the incentive salience of drug cues. Abstract: Background: 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. Method: 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). Results: 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. Conclusions: 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.