Abstract:
BACKGROUND/AIM:Heroin dependence is a chronic relapsing disorder characterized by the compulsion to seek and use heroin. Stress and craving are seen as key factors for heroin use. Moreover, altered hypothalamic-pituitary-adrenal (HPA) axis function has been frequently reported. However, the acute effects of diacetylmorphine (DAM) on HPA axis activity and craving have not been investigated in a controlled study. The present randomized controlled study examined whether DAM administration differs from placebo (saline) administration with regard to HPA axis response and heroin craving. METHODS:In a crossover experiment, 28 DAM-maintained heroin-dependent patients were first injected with DAM and then saline, or the converse. Plasma adrenocorticotropic hormone (ACTH) and cortisol in saliva and serum were measured at baseline and 20 and 60 min after both injections. Heroin craving was measured at baseline and 60 min after both injections, by means of the Heroin Craving Questionnaire. RESULTS:Compared to saline, DAM administration induced a significant decrease in plasma ACTH (p < 0.01), serum cortisol (p < 0.0001) and saliva cortisol (p < 0.01), as well as in craving (p < 0.0001), over time. CONCLUSION:Since acute DAM administration suppresses the stress response, DAM-assisted treatment may be an effective alternative to methadone maintenance in stress-sensitive heroin-dependent patients.
journal_name
Eur Addict Resjournal_title
European addiction researchauthors
Gerber H,Borgwardt SJ,Schmid O,Gerhard U,Joechle W,Riecher-Rössler A,Wiesbeck GA,Walter Mdoi
10.1159/000334411subject
Has Abstractpub_date
2012-01-01 00:00:00pages
116-23issue
3eissn
1022-6877issn
1421-9891pii
000334411journal_volume
18pub_type
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journal_title:European addiction research
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