Laboratory-induced stress and craving among individuals with prescription opioid dependence.
BACKGROUND
Stress and conditioned drug cues have been implicated in the initiation, maintenance and relapse to substances of abuse. Although stress and drug cues are often encountered together, little research exists on whether stress potentiates the response to drug cues.


METHODS
Participants (N=75) were 39 community recruited individuals with current prescription opioid (PO) dependence and 36 healthy controls. Participants stayed overnight in the hospital for one night and then completed laboratory testing the following morning. During laboratory testing, participants were randomly assigned to a stress task (Trier Social Stress Task; TSST) or a no-stress condition. Following the stress manipulation, all participants completed a PO cue paradigm. Immediately before and after the stress and cue tasks, the following were assessed: subjective (stress, craving, anger, sadness, happiness), physiological (heart rate, blood pressure, galvanic skin response), and neuroendocrine responses (cortisol and dehydroepiandrosterone).


RESULTS
Internal validity of the stress task was demonstrated, as evidenced by significantly higher subjective stress, as well as cortisol, heart rate and blood pressure in the TSST compared to the no-stress group. Individuals with PO dependence evidenced significantly greater reactivity to the stress task than controls. Craving increased significantly in response to the drug cue task among PO participants. No stress×cue interaction was observed.


CONCLUSIONS
In this study, heightened stress reactivity was observed among individuals with PO dependence. Exposure to acute stress, however, did not potentiate craving in response to conditioned drug cues.
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States. Electronic address: backs@musc.edu.
Sudie E
SE
Back
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
Daniel F
DF
Gros
Department of Psychology, University of Vermont, Burlington, VT, United States.
Matthew
M
Price
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
Steve
S
LaRowe
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Julianne
J
Flanagan
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
Kathleen T
KT
Brady
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Charles
C
Davis
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Maryanne
M
Jaconis
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Jenna L
JL
McCauley
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D066249:Craving; D003463:Cues; D003687:Dehydroepiandrosterone / Q000378:metabolism; D004644:Emotions / Q000502:physiology; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D009293:Opioid-Related Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D055553:Prescription Drugs / Q000009:adverse effects*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D055815:Young Adult
D055553:Prescription Drugs; D003687:Dehydroepiandrosterone; D006854:Hydrocortisone
Cues; Opiates; Prescription opioids; Stress; Trier