Acute cortisol administration triggers craving in individuals with cocaine dependence

Behavioral Psychopharmacology Research Laboratory, Harvard Medical School/McLean Hospital, Belmont, MA 02478, USA.
Psychopharmacology bulletin (Impact Factor: 0.5). 02/2003; 37(3):84-9.
Source: PubMed


Stress is often mentioned as a factor in the development of drug abuse. Twelve cocaine dependent individuals were administered a stress hormone, cortisol, along with cocaine and saline via intravenous boluses, in a double-blind, counterbalanced fashion. Self-reports of mood states were collected prior to, during, and 20 minutes after each bolus was administered. Cortisol produced significant increases in craving while cocaine significantly elevated all subjective ratings (ie, craving, high, rush, and low). These pilot data suggest that cortisol can induce a state that is associated with drug abuse.

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Available from: Katherine H Karlsgodt, Dec 19, 2014
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    • "For example, a positive correlation between glucocorticoid levels and self-administration of psychostimulants has been observed in rodents (Goeders and Guerin, 1996; Deroche et al., 1997). In addition, drug administration produces stress-like cortisol responses (Broadbear et al., 2004) and similarly, acute administration of cortisol promotes cocaine craving in cocaine-dependent individuals (Elman et al., 2003). These findings not only point to the link between glucocorticoid hormones and addiction (Lovallo, 2006), but also emphasize the need to develop integrative theories explaining the mechanisms by which they affect addictive behavior. "
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    ABSTRACT: Pathological gambling is a behavioral addiction characterized by a chronic failure to resist the urge to gamble. It shares many similarities with drug addiction. Glucocorticoid hormones including cortisol are thought to play a key role in the vulnerability to addictive behaviors, by acting on the mesolimbic reward pathway. Based on our previous report of an imbalanced sensitivity to monetary versus non-monetary incentives in the ventral striatum of pathological gamblers (PGs), we investigated whether this imbalance was mediated by individual differences in endogenous cortisol levels. We used functional magnetic resonance imaging (fMRI) and examined the relationship between cortisol levels and the neural responses to monetary versus non-monetary cues, while PGs and healthy controls were engaged in an incentive delay task manipulating both monetary and erotic rewards. We found a positive correlation between cortisol levels and ventral striatal responses to monetary versus erotic cues in PGs, but not in healthy controls. This indicates that the ventral striatum is a key region where cortisol modulates incentive motivation for gambling versus non-gambling related stimuli in PGs. Our results extend the proposed role of glucocorticoid hormones in drug addiction to behavioral addiction, and help understand the impact of cortisol on reward incentive processing in PGs.
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    • "All of the participants in our study met DSM-IV criteria for cocaine and opioid dependence, and a very large proportion (106 of 114) of them were smokers (Epstein et al. 2010). Laboratory studies have shown that stress increases craving in stimulant, opiate, and tobacco users (Buchmann et al. 2010; Colamussi et al. 2007; Elman et al. 2003; Hamidovic et al. 2010; Hyman et al. 2007; Sinha et al. 1999, 2000). In our EMA data, the relationship between stress and craving may have reflected reciprocal causation: craving itself may induce stress among outpatients who are trying to avoid use. "
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    ABSTRACT: Quantitative real-time data on the stress experienced by drug misusers in their daily lives may provide additional insight into stress's role in drug use. The purpose of this study is to evaluate stress in relation to craving, mood, relapse-trigger exposure, and cocaine use in cocaine-dependent outpatients. Methadone-maintained cocaine- and heroin-abusing outpatients (N = 114) provided ecological momentary assessment data on handheld computers. Ratings of stress were compared to those of craving and mood and past-hour exposure to putative drug-use triggers in randomly prompted entries and in the 5 h prior to participant-initiated cocaine use reports. Stress had significant positive relationships with current ratings of craving for cocaine, heroin, and tobacco and with ratings of tiredness, boredom, and irritation, and had significant negative relationships with ratings of happiness and relaxation. Stress was significantly greater in entries in which participants also reported past-hour exposure to negative-mood triggers, most of the drug-exposure triggers, or any trigger involving thoughts about drugs (e.g., tempted out of the blue). The linear increase in stress during the 5-h preceding individual episodes of cocaine use was not significant (p = 0.12), though there was a trend for such an increase before the use episodes that participants attributed to stressful states when they occurred (p = 0.87). The findings suggest a complex role of stress in addiction. Stress reported in real time in the natural environment showed strong cross-sectional momentary relationships with craving, mood, and exposure to drug-use trigger. However, the prospective association between stress ratings and cocaine-use episodes was, at best, weak.
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    • "As well, reinforcing properties of hedonic stimuli can be enhanced by early stress (Kippin et al., 2007). Similarly, human research indicates that negative life events in adolescence (such as loss of a parent, parental divorce, abuse, etc.), trauma, and certain socio-cultural stressors are all associated with increased vulnerability to engagement in addictive processes (reviewed in Sinha, 2008) and enhancement of cortisol can promote pharmacological addiction (Elman et al., 2003; Sinha et al., 2000). Some of these effects may be related to glucocorticoid actions to enhance central dopamine secretion (Barrot et al., 2001). "
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    ABSTRACT: Sex differences in incidence and severity of some stress-related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic-pituitary-adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or posttraumatic stress disorder (PTSD). Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress-related experiences, will be the subject of future investigation.
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