Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients
Identifieur interne : 001334 ( Istex/Corpus ); précédent : 001333; suivant : 001335Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients
Auteurs : Marc Walter ; Gerhard A. Wiesbeck ; Bigna Degen ; Jürgen Albrich ; Monika Oppel ; André Schulz ; Hartmut Sch Chinger ; Kenneth M. Dürsteler-MacfarlandSource :
- Addiction Biology [ 1355-6215 ] ; 2011-01.
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Abstract
Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (P < 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (P < 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.
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DOI: 10.1111/j.1369-1600.2010.00205.x
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Dürsteler-Macfarland</name><affiliation><mods:affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</mods:affiliation></affiliation><affiliation><mods:affiliation>Psychiatric University Hospital, Division of Substance Use Disorders, University of Zurich, Switzerland</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Addiction Biology</title><idno type="ISSN">1355-6215</idno><idno type="eISSN">1369-1600</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2011-01">2011-01</date><biblScope unit="volume">16</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="145">145</biblScope><biblScope unit="page" to="151">151</biblScope></imprint><idno type="ISSN">1355-6215</idno></series><idno type="istex">725D9AC2FEA74912EA3F388412BE268B132AF636</idno><idno type="DOI">10.1111/j.1369-1600.2010.00205.x</idno><idno type="ArticleID">ADB205</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1355-6215</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cortisol</term><term>diacetylmorphine</term><term>heroin dependence</term><term>methadone</term><term>startle reflex</term><term>stress</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (P < 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (P < 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Marc Walter</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string><json:string>E-mail: marc.walter@upkbs.ch</json:string></affiliations></json:item><json:item><name>Gerhard A. Wiesbeck</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string></affiliations></json:item><json:item><name>Bigna Degen</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string><json:string>Department of Psychology, University of Basel, Switzerland,</json:string></affiliations></json:item><json:item><name>Jürgen Albrich</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string><json:string>Department of Psychology, University of Basel, Switzerland,</json:string></affiliations></json:item><json:item><name>Monika Oppel</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string><json:string>Department of Psychology, University of Basel, Switzerland,</json:string></affiliations></json:item><json:item><name>André Schulz</name><affiliations><json:string>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</json:string></affiliations></json:item><json:item><name>Hartmut Schächinger</name><affiliations><json:string>Department of Psychology, University of Basel, Switzerland,</json:string><json:string>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</json:string></affiliations></json:item><json:item><name>Kenneth M. Dürsteler‐MacFarland</name><affiliations><json:string>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</json:string><json:string>Psychiatric University Hospital, Division of Substance Use Disorders, University of Zurich, Switzerland</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Cortisol</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diacetylmorphine</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>heroin dependence</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>methadone</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>startle reflex</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>stress</value></json:item></subject><articleId><json:string>ADB205</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (P > 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (P > 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.</abstract><qualityIndicators><score>6.494</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1580</abstractCharCount><pdfWordCount>3962</pdfWordCount><pdfCharCount>27673</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>211</abstractWordCount></qualityIndicators><title>Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients</title><refBibs><json:item><author><json:item><name>CJ Auernhammer</name></json:item><json:item><name>U Renner</name></json:item><json:item><name>OA Muller</name></json:item><json:item><name>J Stalla</name></json:item><json:item><name>GK Stalla</name></json:item></author><host><volume>57</volume><pages><last>1027</last><first>1019</first></pages><author></author><title>Neuroendocrinology</title></host><title>Loperamide inhibits corticotrophic cell function by a naloxone‐insensitive mechanism in the rat in vitro</title></json:item><json:item><author><json:item><name>TB Baker</name></json:item><json:item><name>ME Piper</name></json:item><json:item><name>DE McCarthy</name></json:item><json:item><name>MR Majeskie</name></json:item><json:item><name>MC Fiore</name></json:item></author><host><volume>111</volume><pages><last>51</last><first>33</first></pages><author></author><title>Psychol Rev</title></host><title>Addiction motivation reformulated: an affective processing model of negative reinforcement</title></json:item><json:item><author><json:item><name>ES Barratt</name></json:item><json:item><name>JH Patton</name></json:item></author><host><pages><last>122</last><first>77</first></pages><author></author><title>Biological Bases of Sensation Seeking, Impulsivity, and Anxiety</title></host><title>Impulsivity: cognitive, behavioral, and psychophysiological correlates</title></json:item><json:item><author><json:item><name>SG Birnbaum</name></json:item><json:item><name>M Davis</name></json:item></author><host><volume>782</volume><pages><last>323</last><first>318</first></pages><author></author><title>Brain Res</title></host><title>Modulation of acoustic startle reflex by infusion of corticotrophin‐releasing hormone into the nucleus reticularis pontis caudatus</title></json:item><json:item><author><json:item><name>TW Buchanan</name></json:item><json:item><name>A Brechtel</name></json:item><json:item><name>JJ Sollers</name></json:item><json:item><name>WR Lovallo</name></json:item></author><host><volume>68</volume><pages><last>210</last><first>203</first></pages><author></author><title>Pharmacol Biochem Behav</title></host><title>Exogenous cortisol exerts effects on the startle reflex independent of emotional modulation</title></json:item><json:item><author><json:item><name>J Cami</name></json:item><json:item><name>M Gilabert</name></json:item><json:item><name>L San</name></json:item><json:item><name>DL Torre</name></json:item></author><host><volume>87</volume><pages><last>1151</last><first>1145</first></pages><author></author><title>Br J Addict</title></host><title>Hypercortisolismus after opioid discontinuation in rapid detoxification of heroin addicts</title></json:item><json:item><author><json:item><name>CR Cloninger</name></json:item></author><host><volume>44</volume><pages><last>588</last><first>573</first></pages><author></author><title>Arch Gen Psychiatry</title></host><title>A systematic method for clinical description and classification of personality variants. 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Switzerland,</affiliation></author><author xml:id="author-3"><persName><forename type="first">Bigna</forename><surname>Degen</surname></persName><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation></author><author xml:id="author-4"><persName><forename type="first">Jürgen</forename><surname>Albrich</surname></persName><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation></author><author xml:id="author-5"><persName><forename type="first">Monika</forename><surname>Oppel</surname></persName><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation></author><author xml:id="author-6"><persName><forename type="first">André</forename><surname>Schulz</surname></persName><affiliation>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</affiliation></author><author xml:id="author-7"><persName><forename type="first">Hartmut</forename><surname>Schächinger</surname></persName><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation><affiliation>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</affiliation></author><author xml:id="author-8"><persName><forename type="first">Kenneth M.</forename><surname>Dürsteler‐MacFarland</surname></persName><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Psychiatric University Hospital, Division of Substance Use Disorders, University of Zurich, Switzerland</affiliation></author></analytic><monogr><title level="j">Addiction Biology</title><idno type="pISSN">1355-6215</idno><idno type="eISSN">1369-1600</idno><idno type="DOI">10.1111/(ISSN)1369-1600</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2011-01"></date><biblScope unit="volume">16</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="145">145</biblScope><biblScope unit="page" to="151">151</biblScope></imprint></monogr><idno type="istex">725D9AC2FEA74912EA3F388412BE268B132AF636</idno><idno type="DOI">10.1111/j.1369-1600.2010.00205.x</idno><idno type="ArticleID">ADB205</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (P < 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (P < 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>Cortisol</term></item><item><term>diacetylmorphine</term></item><item><term>heroin dependence</term></item><item><term>methadone</term></item><item><term>startle reflex</term></item><item><term>stress</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/725D9AC2FEA74912EA3F388412BE268B132AF636/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1369-1600</doi><issn type="print">1355-6215</issn><issn type="electronic">1369-1600</issn><idGroup><id type="product" value="ADB"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ADDICTION BIOLOGY">Addiction Biology</title></titleGroup></publicationMeta><publicationMeta level="part" position="01101"><doi origin="wiley">10.1111/adb.2011.16.issue-1</doi><numberingGroup><numbering type="journalVolume" number="16">16</numbering><numbering type="journalIssue" number="1">1</numbering></numberingGroup><coverDate startDate="2011-01">January 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="16" status="forIssue"><doi origin="wiley">10.1111/j.1369-1600.2010.00205.x</doi><idGroup><id type="unit" value="ADB205"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">HUMAN/CLINICAL STUDIES</title></titleGroup><copyright>© 2010 The Authors, Addiction Biology © 2010 Society for the Study of Addiction</copyright><eventGroup><event type="firstOnline" date="2010-11-29"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-03-10"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.27 mode:FullText" date="2010-11-29"></event><event type="publishedOnlineFinalForm" date="2010-11-29"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2013-12-31"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="145">145</numbering><numbering type="pageLast" number="151">151</numbering></numberingGroup><correspondenceTo>Marc Walter, Psychiatric Hospital of the University of Basel, Wilhelm Klein‐Str. 27, CH‐4025 Basel, Switzerland. E‐mail: <email>marc.walter@upkbs.ch</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ADB.ADB205.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="47"></count><count type="wordTotal" number="4511"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients</title><title type="shortAuthors">Marc Walter et al.</title><title type="short">Heroin reduces startle and cortisol response</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Marc</givenNames><familyName>Walter</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Gerhard A.</givenNames><familyName>Wiesbeck</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1 #a2"><personName><givenNames>Bigna</givenNames><familyName>Degen</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1 #a2"><personName><givenNames>Jürgen</givenNames><familyName>Albrich</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1 #a2"><personName><givenNames>Monika</givenNames><familyName>Oppel</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a3"><personName><givenNames>André</givenNames><familyName>Schulz</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a2 #a3"><personName><givenNames>Hartmut</givenNames><familyName>Schächinger</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1 #a4"><personName><givenNames>Kenneth M.</givenNames><familyName>Dürsteler‐MacFarland</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="CH"><unparsedAffiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CH"><unparsedAffiliation>Department of Psychology, University of Basel, Switzerland,</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="DE"><unparsedAffiliation>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="CH"><unparsedAffiliation>Psychiatric University Hospital, Division of Substance Use Disorders, University of Zurich, Switzerland</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Cortisol</keyword><keyword xml:id="k2">diacetylmorphine</keyword><keyword xml:id="k3">heroin dependence</keyword><keyword xml:id="k4">methadone</keyword><keyword xml:id="k5">startle reflex</keyword><keyword xml:id="k6">stress</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">ABSTRACT</title><p>Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (<i>P</i> < 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (<i>P</i> < 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Heroin reduces startle and cortisol response</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Heroin reduces startle and cortisol response in opioid‐maintained heroin‐dependent patients</title></titleInfo><name type="personal"><namePart type="given">Marc</namePart><namePart type="family">Walter</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>E-mail: marc.walter@upkbs.ch</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gerhard A.</namePart><namePart type="family">Wiesbeck</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bigna</namePart><namePart type="family">Degen</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jürgen</namePart><namePart type="family">Albrich</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Monika</namePart><namePart type="family">Oppel</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">André</namePart><namePart type="family">Schulz</namePart><affiliation>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hartmut</namePart><namePart type="family">Schächinger</namePart><affiliation>Department of Psychology, University of Basel, Switzerland,</affiliation><affiliation>Institute of Psychobiology, Department of Clinical Physiology, University of Trier, Germany and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kenneth M.</namePart><namePart type="family">Dürsteler‐MacFarland</namePart><affiliation>Psychiatric Hospital, Division of Substance Use Disorders, University of Basel, Switzerland,</affiliation><affiliation>Psychiatric University Hospital, Division of Substance Use Disorders, University of Zurich, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2011-01</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">1</extent><extent unit="references">47</extent><extent unit="words">4511</extent></physicalDescription><abstract lang="en">Heroin dependence (HD) is a chronic relapsing brain disorder characterized by a compulsion to seek and use heroin. Stress is seen as a key factor for heroin use. Methadone maintenance and the prescription of pharmaceutical heroin [diacetylmorphine (DAM)] are established treatments for HD in several countries. The present study examined whether DAM‐maintained patients and methadone‐maintained patients differ from healthy controls in startle reflex and cortisol levels. Fifty‐seven participants, 19 of each group matched for age, sex and smoking status, completed a startle session which included the presentation of 24 bursts of white noise while eye‐blink responses to startling noises were recorded. Salivary cortisol was collected three times after awakening, before, during and after the startle session. DAM was administered before the experiment, while methadone was administered afterwards. Both heroin‐dependent patient groups exhibited significantly smaller startle responses than healthy controls (P < 0.05). Whereas the cortisol levels after awakening did not differ across the three groups, the experimental cortisol levels were significantly lower in DAM‐maintained patients, who received their opioid before the experiment, than in methadone‐maintained patients and healthy controls (P < 0.0001). Opioid maintenance treatment for HD is associated with reduced startle responses. Acute DAM administration may suppress cortisol levels, and DAM maintenance treatment may represent an effective alternative to methadone in stress‐sensitive, heroin‐dependent patients.</abstract><subject lang="en"><genre>keywords</genre><topic>Cortisol</topic><topic>diacetylmorphine</topic><topic>heroin dependence</topic><topic>methadone</topic><topic>startle reflex</topic><topic>stress</topic></subject><relatedItem type="host"><titleInfo><title>Addiction Biology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1355-6215</identifier><identifier type="eISSN">1369-1600</identifier><identifier type="DOI">10.1111/(ISSN)1369-1600</identifier><identifier type="PublisherID">ADB</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>16</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>145</start><end>151</end><total>7</total></extent></part></relatedItem><identifier type="istex">725D9AC2FEA74912EA3F388412BE268B132AF636</identifier><identifier type="DOI">10.1111/j.1369-1600.2010.00205.x</identifier><identifier type="ArticleID">ADB205</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2010 The Authors, Addiction Biology © 2010 Society for the Study of Addiction</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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