title: Sustained incentive value of heroin-related cues in short- and long-term abstinent heroin users.
abstract: Models of addiction and addiction memory propose that drug-associated cues elicit incentive effects in drug users, which play an important role in maintenance of drug use and relapse. Incentive effects have been demonstrated for smoking and alcohol-related cues but evidence for heroin-related cues has been inconclusive. Furthermore, it is unknown whether appetitive effects of heroin-related cues persist after prolonged abstinence, although heroin addiction is known to have high relapse rates. Therefore, we investigated implicit and explicit valence of heroin-related cues in dependent users at different stages of abstinence using affective startle modulation. In Study I, 15 current heroin users were measured before and after detoxification. Correspondingly, 15 healthy control participants were tested twice at an interval of 14 days. In Study II, 14 long-term abstinent heroin users were additionally measured in a single session. Implicit processing of drug-related stimuli was assessed using affective startle modulation by pictures of heroin and smoking scenes. Explicit reactions were measured using ratings of valence and craving. In contrast to controls, heroin-dependent participants showed a clear reduction of startle response during heroin-related pictures (p<0.05). Detoxification did not significantly change their startle responses to heroin-cues. No difference between non-detoxified current and long-term abstinent heroin users was found in implicit reactions to heroin-cues, whereas explicit measures differed between both groups (all p<0.05). After detoxification and even after prolonged abstinence, heroin cues still exert implicit appetitive effects in heroin users. This implies that drug-induced adaptations of reward circuits are long-lasting, resulting in a highly stable addiction memory.
authors.affiliation: Experimental and Clinical Pharmacopsychology, Clinic of Affective Disorders and General Psychiatry, University Hospital of Psychiatry, University of Zurich, Switzerland. Electronic address: preller@bli.uzh.ch.
authors.forename: Katrin H
authors.initials: KH
authors.lastname: Preller
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.forename: Christian
authors.initials: C
authors.lastname: Sulzbach
authors.forename: Klaus
authors.initials: K
authors.lastname: Hoenig
authors.forename: Julia
authors.initials: J
authors.lastname: Neubauer
authors.forename: Petra E
authors.initials: PE
authors.lastname: Franke
authors.forename: Nadine
authors.initials: N
authors.lastname: Petrovsky
authors.forename: Ingo
authors.initials: I
authors.lastname: Frommann
authors.forename: Anne K
authors.initials: AK
authors.lastname: Rehme
authors.forename: Boris B
authors.initials: BB
authors.lastname: Quednow
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016739:Behavior, Addictive / Q000209:etiology / Q000517:prevention & control*; D003131:Combined Modality Therapy; D003463:Cues; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009042:Motivation; D058850:Opiate Substitution Treatment; D010775:Photic Stimulation / Q000009:adverse effects*; D010781:Photography; D013216:Reflex, Startle; D055502:Secondary Prevention; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone