Laboratory-induced cue reactivity among individuals with prescription opioid dependence

Abstract

Prescription opioid (PO) dependence is a critical health problem. Although examination of drug cue reactivity paradigms has advanced the understanding of risk factors for relapse for a variety of substances (e.g., cocaine, alcohol, nicotine), no PO specific drug cue paradigm has been developed. The current study addressed this gap in the literature and evaluated the ability of a newly developed PO drug cue paradigm to elicit subjective, physiological, and neuroendocrine changes among PO-dependent participants (n = 20) as compared to controls (n = 17). The drug cue paradigm included an induction script, viewing and handling paraphernalia (e.g., bottle of oxycontin pills, pill crusher) and watching a video depicting people using POs as well as places related to POs (e.g., pharmacies). Consistent with hypotheses, the PO group demonstrated significant pre- to post-cue increases on subjective ratings of craving, difficulty resisting POs, stress, and anger. The control group did not demonstrate significant changes on any of the subjective measures. Both the PO group and the control group evidenced significant pre- to post-cue increases in physiological responses (e.g., blood pressure, skin conductance), as expected given the arousing nature of the drug cue stimuli. The PO group, but not the control group, evidenced a significant pre- to post-cue increase in heart rate and salivary cortisol levels. The development and validation of a drug cue paradigm for POs may help inform future research and treatment development efforts for patients with PO dependence.

Laboratory-induced stress and craving among individuals with prescription opioid dependence

“…As previously reported (Back et al, 2014), exposure to the drug cue task alone resulted in significant increases from pre to post in subjective (craving, stress, anger, difficulty resisting opioids), physiological (heart rate), and cortisol levels among PO participants, but not controls. Physiological and neuroendocrine responses to the stress task were predictive of these same responses to the drug cue paradigm.…”

“…The TSST is a standardized, 15-minute stress provocation (Kirschbaum et al, 1993) which consists of three components: (a) participants are given 5 minutes to think about and prepare to give a speech, (b) participants deliver a 5-minute speech to 3 confederates, and then (c) participants verbally complete serial subtractions for 5 minutes before the same audience. Following the TSST or no-stress condition, all participants completed a 15-minute PO drug cue paradigm (Back et al, 2014). The drug cue paradigm consists of three components: (a) a 5-minute audio induction script, which guides participants to relax and then think about the last time they used POs in detail; (b) 5 minutes viewing and handling drug paraphernalia; and (c) 5-minute watching a video depicting people using POs in a variety of ways.…”

“…In contrast to other types of SUD, individuals with PO use disorders may have different initiation histories (e.g., prescribed the drug by their physician, initially consumed by some for legitimate physical health reasons) and may present with different comorbidities, such as chronic pain, that could exert influences on stress reactivity. Using a human laboratory stress induction task (Back et al, 2014), the current study examined stress reactivity among individuals with and without PO dependence, as well as the interaction of stress and conditioned PO drug cues. Human laboratory paradigms offer a high degree of methodological precision and control, and are a reliable method of investigating the complexities of stress (Foley and Kirschbaum, 2010) and conditioned drug cues.…”

Physiological Indicators of Pathologic Video Game Use in Adolescence

“…Research literature shows that abnormally high SNS activity, measured by SC levels and higher SC reactivity to stress, is indicative of high anxiety and fear, as well as low emotion regulation [15,25,26], but abnormally high SNS activity has not yet been used as an indicator for possible PVGU. A number of studies find that higher levels of SC are related to substance use addiction [27] and gambling addiction [28]. Accordingly, we would expect high SC to also predict higher levels of PVGU across adolescence.…”

Gender moderates the association between distress tolerance and alcohol use among individuals with opioid use disorder

“…A total of 122 non-treatment seeking participants were recruited as part of a larger laboratory study examining prescription opioid use and stress, which included an overnight hospital stay (Back et al, 2014). Participants had current (past 6 months) prescription OUD defined as meeting the DSM-IV (American Psychiatric Association, 2000) criteria for substance use dependence on opioid analgesics.…”