Dysfunction of the Hypothalamic-Pituitary-Adrenal Axis in Opioid Dependent Subjects: Effects of Acute and Protracted Abstinence

Objectives: The function of the Hypothalamic-Pituitary-Adrenal (HPA) axis during opioid dependence has been inconsistent. We compared HPA axis measures between subjects during methadone stabilization and drug-free detoxification with healthy controls. Methods: Sixty heroin dependent patients receive...

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Bibliographic Details
Published in:The American journal of drug and alcohol abuse Vol. 34; no. 6; pp. 760 - 768
Main Authors: Zhang, Guo-Fu, Ren, Yan-Ping, Sheng, Li-Xia, Chi, Yong, Du, Wan-Jun, Guo, Song, Jiang, Zuo-Ning, Xiao, Le, Luo, Xiao-Nian, Tang, Yi-Lang, Smith, Alicia K., Liu, Zhen-Qi, Zhang, Hong-Xi
Format: Journal Article
Language:English
Published: Colchester Informa UK Ltd 01.01.2008
Taylor & Francis
Taylor & Francis Ltd
Subjects:
ACTH
Addictive behaviors
Adrenocorticotropic Hormone - blood
Adult
Adult and adolescent clinical studies
Benzodiazepines
Benzodiazepines - therapeutic use
Biological and medical sciences
Clonidine
Clonidine - therapeutic use
Comparative analysis
Corticotropin-Releasing Hormone - blood
Cortisol
CRH
Detoxification
Drug addiction
Drug dependency
Drug replacement therapy
Drug therapy
Female
Heroin
Heroin Dependence - physiopathology
Heroin Dependence - rehabilitation
Hormones
HPA axis
Humans
Hydrocortisone - blood
Hypothalamic-pituitary-adrenal axis
Hypothalamo-Hypophyseal System - physiopathology
Male
Medical sciences
Medical treatment
Methadone
Methadone - therapeutic use
opioid dependence
Opioids
Patients
Pituitary gland
Pituitary-Adrenal System - physiopathology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Serum
Stabilization
Substance Withdrawal Syndrome - physiopathology
Treatment
Young Adult
Hypothalamohypophysoadrenal axis
Corticotropin releasing factor
ACTH
Opiates
Cortisol
HPA axis
Hydrocortisone
Glucocorticoid
Dependence
Hormone releasing factor
Human
Corticosteroid
Drug addiction
Steroid hormone
Acute
Substance abuse
Abstinence
Hypothalamic hormone
Adrenocorticotropic hormone
Adenohypophyseal hormone
Addiction
Dysfunction
Adrenal hormone
CRH
opioid dependence
ISSN:0095-2990, 1097-9891, 1097-9891
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Summary:Objectives: The function of the Hypothalamic-Pituitary-Adrenal (HPA) axis during opioid dependence has been inconsistent. We compared HPA axis measures between subjects during methadone stabilization and drug-free detoxification with healthy controls. Methods: Sixty heroin dependent patients received either non-opiate treatment (NOT) with benzodiazepines and clonidine (n = 30) or methadone stabilization treatment (MT, n = 30), and their serum levels of corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol (COR) were measured and compared to those of healthy, nondependent controls. Results: Compared with healthy controls, CRH was significantly lower (p <. 001) while COR was higher (p <. 001) during acute withdrawal in the NOT group. CRH and COR was lower (p <. 001), while ACTH was normal in the MT group compared to healthy controls. Conclusions: Our findings suggest that chronic opioid dependence may cause reduced function of the HPA axis, while opioid withdrawal may decrease the response of the pituitary to CRH and increase the adrenal response to ACTH.
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ISSN:0095-2990
1097-9891
1097-9891
DOI:10.1080/00952990802385781