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Vol. 18, No. 3, 2012
Issue release date: April 2012
Section title: Research Report
Eur Addict Res 2012;18:116–123
(DOI:10.1159/000334411)

The Impact of Diacetylmorphine on Hypothalamic-Pituitary-Adrenal Axis Activity and Heroin Craving in Heroin Dependence

Gerber H.a, b · Borgwardt S.J.a · Schmid O.a · Gerhard U.a · Joechle W.c · Riecher-Rössler A.a · Wiesbeck G.A.a · Walter M.a
aPsychiatric Hospital, University of Basel, bDepartment of Psychology, University of Basel, and cLaboratory Medicine, University Hospital Basel, Basel, Switzerland

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Article / Publication Details

First-Page Preview
Abstract of Research Report

Received: 8/23/2011 11:56:15 AM
Published online: 1/24/2012
Issue release date: April 2012

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 2

ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)

For additional information: http://www.karger.com/EAR

Abstract

Background/Aim: Heroin dependence is a chronic relapsing disorder characterized by the compulsion to seek and use heroin. Stress and craving are seen as key factors for heroin use. Moreover, altered hypothalamic-pituitary-adrenal (HPA) axis function has been frequently reported. However, the acute effects of diacetylmorphine (DAM) on HPA axis activity and craving have not been investigated in a controlled study. The present randomized controlled study examined whether DAM administration differs from placebo (saline) administration with regard to HPA axis response and heroin craving. Methods: In a crossover experiment, 28 DAM-maintained heroin-dependent patients were first injected with DAM and then saline, or the converse. Plasma adrenocorticotropic hormone (ACTH) and cortisol in saliva and serum were measured at baseline and 20 and 60 min after both injections. Heroin craving was measured at baseline and 60 min after both injections, by means of the Heroin Craving Questionnaire. Results: Compared to saline, DAM administration induced a significant decrease in plasma ACTH (p < 0.01), serum cortisol (p < 0.0001) and saliva cortisol (p < 0.01), as well as in craving (p < 0.0001), over time. Conclusion: Since acute DAM administration suppresses the stress response, DAM-assisted treatment may be an effective alternative to methadone maintenance in stress-sensitive heroin-dependent patients.

© 2012 S. Karger AG, Basel


  

Author Contacts

Hana Gerber, lic. phil.
Universitäre Psychiatrische Kliniken (UPK), Abhängigkeitserkrankungen
Wilhelm Klein-Strasse 27
CH–4012 Basel (Switzerland)
Tel. +41 61 325 56 86, E-Mail hana.gerber@upkbs.ch

  

Article Information

Received: August 23, 2011
Published online: January 24, 2012
Number of Print Pages : 8
Number of Figures : 4, Number of Tables : 2, Number of References : 52

  

Publication Details

European Addiction Research

Vol. 18, No. 3, Year 2012 (Cover Date: April 2012)

Journal Editor: van den Brink W. (Amsterdam), Kiefer F. (Mannheim)
ISSN: 1022-6877 (Print), eISSN: 1421-9891 (Online)

For additional information: http://www.karger.com/EAR


Article / Publication Details

First-Page Preview
Abstract of Research Report

Received: 8/23/2011 11:56:15 AM
Published online: 1/24/2012
Issue release date: April 2012

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 2

ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)

For additional information: http://www.karger.com/EAR


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