title: Dysfunction of the hypothalamic-pituitary-adrenal axis in opioid dependent subjects: effects of acute and protracted abstinence.
abstract: OBJECTIVE
  The function of the Hypothalamic-Pituitary-Adrenal (HPA) axis during opioid dependence has been inconsistent. We compared HPA axis measures between subjects during methadone stabilization and drug-free detoxification with healthy controls.
  
  
  METHODS
  Sixty heroin dependent patients received either non-opiate treatment (NOT) with benzodiazepines and clonidine (n = 30) or methadone stabilization treatment (MT, n = 30), and their serum levels of corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol (COR) were measured and compared to those of healthy, nondependent controls.
  
  
  RESULTS
  Compared with healthy controls, CRH was significantly lower (p < .001) while COR was higher (p < .001) during acute withdrawal in the NOT group. CRH and COR was lower (p < .001), while ACTH was normal in the MT group compared to healthy controls.
  
  
  CONCLUSIONS
  Our findings suggest that chronic opioid dependence may cause reduced function of the HPA axis, while opioid withdrawal may decrease the response of the pituitary to CRH and increase the adrenal response to ACTH.
authors.affiliation: Beijing Anding Hospital, Capital University of Medical Sciences, Beijing, China.
authors.forename: Guo-Fu
authors.initials: GF
authors.lastname: Zhang
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Ren
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Sheng
authors.forename: Yong
authors.initials: Y
authors.lastname: Chi
authors.forename: Wan-Jun
authors.initials: WJ
authors.lastname: Du
authors.forename: Song
authors.initials: S
authors.lastname: Guo
authors.forename: Zuo-Ning
authors.initials: ZN
authors.lastname: Jiang
authors.forename: Le
authors.initials: L
authors.lastname: Xiao
authors.forename: Xiao-Nian
authors.initials: XN
authors.lastname: Luo
authors.forename: Yi-Lang
authors.initials: YL
authors.lastname: Tang
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Smith
authors.forename: Zhen-Qi
authors.initials: ZQ
authors.lastname: Liu
authors.forename: Hong-Xi
authors.initials: HX
authors.lastname: Zhang
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001569:Benzodiazepines / Q000627:therapeutic use; D003000:Clonidine / Q000627:therapeutic use; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D005260:Female; D006556:Heroin Dependence / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D001569:Benzodiazepines; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D003000:Clonidine; D008691:Methadone; D006854:Hydrocortisone