Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

Abstract

Rationale-Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior.Objective-The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior.Materials and methods-Subjects (n=19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/ dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed.Results-We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch.Conclusions-In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.

Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving

“…Craving-related BOLD signals were obtained from the sham TMS sessions and regressed against the relative subjective craving level. The individual variation in the mOFC signal was significantly explained by the subjective variance in craving in both the immediate [F (1,8) = 13.4, P < 0.01] and delayed condition [F (1,8) = 7.2, P < 0.05] as shown in Fig. 2C, indicating that mOFC activity reflected the subjective valuation of drug-related stimuli.…”

“…Behavioral economists propose that drug cues increase the marginal utility of the drug, favoring the decision to consume (3,5,6). Indeed, cue-induced craving reflects the subjective value of drug use (7) and predicts drug-seeking behaviors (8,9), but is also amenable to self-control (6,10). Cue-induced craving is affected by a variety of contexts and events that impact self-control, such as perceived drug availability (11)(12)(13)(14), expectancy (15), stress (16), or intention to seek treatment (17).…”

Transdisciplinary Tobacco Use Research Centers: Research achievements and future implications

“…Other TTURC researchers are testing the potential value of mecamylamine, a nicotine antagonist, in the treatment of alcohol drinking. McKee, Krishnan-Sarin, Shi, Mase, and O'Malley (2006) are examining whether varenicline, a partial agonist, attenuates the adverse effect of alcohol on ability to resist smoking using a laboratory model developed in the TTURC and whether varenicline reduces alcohol drinking among heavy-drinking smokers using a paradigm in which benefi cial effects of NRT were demonstrated ( McKee, O'Malley, Shi, Mase, & Krishnan-Sarin, 2008 ).…”

Differences in Subjective Response to Alcohol by Gender, Family History, Heavy Episodic Drinking, and Cigarette Use: Refining and Broadening the Scope of Measurement

“…A third important limitation is that differences in SR have been identified based on several other alcoholrelated risk factors, including gender (e.g., Luczak et al, 2002;Miller et al, 2009), race (Pedersen & McCarthy, 2013;Plebani et al, 2011), and cigarette smoking status (e.g., Cooney et al, 2001;McKee et al, 2008). However, study findings have been inconsistent, making it difficult to identify distinct profiles of risk associated with these demographic characteristics.…”

“…Some studies have found that nicotine (administered via smoking, intranasally, or by transdermal patch) reduces craving for alcohol (Cooney et al, 2001) and attenuates the experience of intoxication and/or reduces ad libitum drinking (McKee et al, 2008), whereas others suggest that nicotine use increases subjective intoxication and craving (Kouri et al, 2004) and, for men, results in increased self-administration (Acheson et al, 2006).…”