Dysfunction of the hypothalamic-pituitary-adrenal axis in opioid dependent subjects: effects of acute and protracted abstinence.
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.
Zhang
Guo-Fu
GF
Beijing Anding Hospital, Capital University of Medical Sciences, Beijing, China.
Ren
Yan-Ping
YP
Sheng
Li-Xia
LX
Chi
Yong
Y
Du
Wan-Jun
WJ
Guo
Song
S
Jiang
Zuo-Ning
ZN
Xiao
Le
L
Luo
Xiao-Nian
XN
Tang
Yi-Lang
YL
Smith
Alicia K
AK
Liu
Zhen-Qi
ZQ
Zhang
Hong-Xi
HX
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
D001569:Benzodiazepines; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D003000:Clonidine; D008691:Methadone; D006854:Hydrocortisone