Cue-induced cocaine craving enhances psychosocial stress and vice versa in chronic cocaine users

Abstract

There is evidence that stress and craving contribute to the development, maintenance, and relapse in cocaine use disorder. Previous research has shown altered physiological responses to psychosocial stress as well as increased vegetative responding to substance-related cues in chronic cocaine users (CU). However, how psychosocial stress and cue-induced craving interact in relation to the physiological response of CU is largely unknown. Therefore, we investigated the interaction between acute psychosocial stress and cocaine-cue-related reactivity in 47 CU and 38 controls. Participants were randomly exposed first to a video-based cocaine-cue paradigm and second to the Trier Social Stress Test (TSST) or vice versa in a crossed and balanced design to investigate possible mutually augmenting effects of both stressors on the physiological stress response. Plasma cortisol, ACTH, and noradrenaline as well as subjective stress and craving were assessed repeatedly over the course of the experimental procedure. Growth models and discontinuous growth models were used to estimate the responses during the cocaine-cue paradigm and TSST. Overall, both groups did not differ in their endocrinological responses to the TSST but CU displayed lower ACTH levels at baseline. The TSST did not elevate craving in CU. However, if the cocaine-cue video was shown first, CU displayed an enhanced cortisol response to the subsequent TSST. Cocaine-cues robustly evoked craving in CU but no stress response, while cue-induced craving was intensified after the TSST. Taken together, CU did not show an altered acute stress response during the TSST but stress and craving together seem to have mutually augmenting effects on their stress response.

A longitudinal investigation of blood neurofilament light chain levels in chronic cocaine users

“…The data were collected in the context of the Social Stress Cocaine Study (SSCP) at the Psychiatric Hospital of the University of Zurich. 15,25 The general exclusion criteria were a family history of genetically transmitted psychiatric disorders (h 2 >0.5, e.g., autism, schizophrenia, or bipolar disorder); any severe neurological disorder or brain injury; a current diagnosis of infectious disease or severe somatic disorder; a history of autoimmune, endocrine, or rheumatoid arthritis; intake of medication with potential action on the central nervous system or the physiological stress system during the previous three days; participation in a large previous study conducted by our lab, the Zurich Cocaine Cognition Study; 7,10 and (for women) being pregnant or breastfeeding. The criteria for inclusion of CU in the study were cocaine as the primary substance of use; a lifetime cumulative consumption of at least 100 g of cocaine, estimated by self-report; and a current abstinence duration of <6 months.…”

A Longitudinal Investigation of Blood Neurofilament Light Chain Levels in Chronic Cocaine Users

“…The data were collected in the context of the Social Stress Cocaine Study (SSCP) at the Psychiatric Hospital of the University of Zurich. [15,26] The general exclusion criteria were a family history of genetically transmitted psychiatric disorders (h 2 >0.5, e.g., autism, schizophrenia, or bipolar disorder); any severe neurological disorder or brain injury; a current diagnosis of infectious disease or severe somatic disorder; a history of autoimmune, endocrine, or rheumatoid arthritis; intake of medication with potential action on the central nervous system or the physiological stress system during the previous 72h; participation in a large previous study conducted by our lab, the Zurich Cocaine Cognition Study [7,10]; and (for women) being pregnant or breastfeeding. The criteria for inclusion of CU in the study were cocaine as the primary substance of use; a lifetime cumulative consumption of at least 100 g of cocaine, estimated by self-report; and a current abstinence duration of <6 months.…”

Repeated footshock stress induces an escalation of cocaine self-administration in male and female rats: Role of the cannabinoid receptor 1

“…Stress has been identified as a potential driver of cocaine use and craving for individuals with CUD. Indeed, experimentally delivered stressors increased cocaine craving for individuals who were cocaine-abstinent (Sinha and Li, 2007) and recent users (Kexel et al, 2022). Further, early life stress is a strong predictor for cocaine use disorder (Felitti, 2003;Elton et al, 2014;Spatz Widom et al, 1999;Rovaris et al, 2015), and CUD is strongly associated with stress-associated psychiatric illness (Chen et al, 2011).…”