Nicotine as a factor in stress responsiveness among detoxified alcoholics.
OBJECTIVE
The effect of transdermal nicotine on stress reactivity was investigated in currently smoking, detoxified, substance-dependent individuals (65% alcohol dependent, n = 51; 31 male) following a psychosocial stressor.


METHODS
Using a randomized, double-blind, placebo-controlled design, subjects were assigned to receive either active transdermal nicotine (low or high dose) or placebo. Six hours following nicotine administration, subjects performed a laboratory psychosocial stressor consisting of two 4-min public-speaking sessions.


RESULTS
Consistent with prior reports, substance-dependent individuals displayed a blunted stress response. However, a review of the cortisol distribution data encouraged additional analyses. Notably, a significant minority of the substance-dependent individuals (33%) demonstrated elevated poststress cortisol levels. This group of responders was more likely to be alcohol dependent and to have received the high dose of nicotine [χ2(2) = 32, P < 0.0001], [χ2(2) = 18.66, P < 0.0001]. Differences in salivary cortisol responses between responders and nonresponders could not be accounted for by the length of sobriety, nicotine withdrawal levels, anxiety or depressive symptomatology at the time of the psychosocial stressor.


CONCLUSIONS
These results suggest that nicotine administration may support a normalization of the salivary cortisol response following psychosocial stress in subgroups of substance-dependent individuals, particularly those who are alcohol dependent. Given the association between blunted cortisol levels and relapse, and the complex actions of nicotine at central and peripheral sites, these findings support the systematic study of factors including nicotine, which may influence stress reactivity and the recovery process in alcohol-dependent individuals.
Department of Psychology, Lycoming College, 700 College Place, Williamsport, PA 17701, USA. gilbertr@lycoming.edu
Rebecca
R
Gilbertson
Reginald F
RF
Frye
Sara Jo
SJ
Nixon
D000279:Administration, Cutaneous; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology* / Q000628:therapy; D001007:Anxiety / Q000150:complications; D003863:Depression / Q000150:complications; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D011569:Psychiatric Status Rating Scales; D012907:Smoking / Q000523:psychology; D013312:Stress, Physiological / Q000187:drug effects*; D013375:Substance Withdrawal Syndrome / Q000150:complications / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology*
D009538:Nicotine; D006854:Hydrocortisone