title: Cue-induced reactivity, cortisol response and substance use outcome in treated heroin dependent individuals.
abstract: BACKGROUND
  Environmental stimuli associated with drug taking have been known to elicit drug craving and physiologic arousal, as well as hypothalamic-pituitary-adrenal axis activation. However, the relationship between these responses and substance use outcomes in heroin-dependent subjects has not been previously studied. We investigated the relationship among subjective and physiologic reactivity, biological stress response evoked in the laboratory, and relapse to substance use in treated opiate-dependent individuals.
  
  
  METHODS
  Eighteen opiate-abstinent methadone- or buprenorphine-treated patients and 13 control subjects were exposed to neutral- and drug-cue exposure laboratory sessions with a 3-month follow-up period. Exposure to cues involved both videotapes and handling during a 100-min session. Subjective craving, agonistic effects, withdrawal feelings, galvanic skin resistance, and salivary cortisol were assessed. Substance use outcome among patients was examined during the follow-up phase. Differences between relapsers, nonrelapsers, and controls were analyzed with respect to the data on drug-cue responsivity and on cortisol responses using repeated-measures analysis of variance. The association with substance use outcome was assessed using a nominal logistic model.
  
  
  RESULTS
  Relapsers experienced greater drug-cue induced subjective responses and an increased cortisol response compared with both nonrelapsers and control subjects. After adjusting on covariates, cue-induced cortisol response was associated with the relapser group and was highly correlated with self-reports of "high."
  
  
  CONCLUSIONS
  Subjects defined as relapsers presented a higher cue-induced reactivity during the drug-cue exposure as well as an increased cortisol response to drug cues. Higher cortisol response to drug cues may increase relapse vulnerability in stable-dose buprenorphine or methadone-maintained subjects.
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France; Département d'Addictologie, Centre Hospitalier Universitaire de Bordeaux et Centre Hospitalier Charles Perrens, Bordeaux, France.
authors: Melina
authors: M
authors: Fatseas
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France; Département d'Addictologie, Centre Hospitalier Universitaire de Bordeaux et Centre Hospitalier Charles Perrens, Bordeaux, France.
authors: Cécile
authors: C
authors: Denis
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France; Département d'Addictologie, Centre Hospitalier Universitaire de Bordeaux et Centre Hospitalier Charles Perrens, Bordeaux, France.
authors: Zoé
authors: Z
authors: Massida
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France.
authors: Magali
authors: M
authors: Verger
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France; Département d'Addictologie, Centre Hospitalier Universitaire de Bordeaux et Centre Hospitalier Charles Perrens, Bordeaux, France.
authors: Pascale
authors: P
authors: Franques-Rénéric
authors: Laboratoire de Psychiatrie/Sanpsy Centre National de la Recherche Scientifique-Unité de Service et de Recherche 3413, Université Bordeaux Segalen, Bordeaux, France; Département d'Addictologie, Centre Hospitalier Universitaire de Bordeaux et Centre Hospitalier Charles Perrens, Bordeaux, France. Electronic address: marc.auriacombe@labopsy.u-bordeaux2.fr.
authors: Marc
authors: M
authors: Auriacombe
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use; D003463:Cues; D058999:Drug-Seeking Behavior / Q000187:drug effects / Q000502:physiology; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology*; D006556:Heroin Dependence / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology*; D012008:Recurrence; D012463:Saliva / Q000378:metabolism
chemical_list: D002047:Buprenorphine; D008691:Methadone; D006854:Hydrocortisone