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D'Ottavio G, Reverte I, Ragozzino D, Meringolo M, Milella MS, Boix F, Venniro M, Badiani A, Caprioli D. Increased heroin intake and relapse vulnerability in intermittent relative to continuous self-administration: Sex differences in rats. Br J Pharmacol 2023; 180:910-926. [PMID: 34986504 PMCID: PMC9253203 DOI: 10.1111/bph.15791] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 12/02/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Studies using intermittent-access drug self-administration show increased motivation to take and seek cocaine and fentanyl, relative to continuous access. In this study, we examined the effects of intermittent- and continuous-access self-administration on heroin intake, patterns of self-administration and cue-induced heroin-seeking, after forced or voluntary abstinence, in male and female rats. We also modelled brain levels of heroin and its active metabolites. EXPERIMENTAL APPROACH Rats were trained to self-administer a palatable solution and then heroin (0.075 mg·kg-1 per inf) either continuously (6 h·day-1 ; 10 days) or intermittently (6 h·day-1 ; 5-min access every 30-min; 10 days). Brain levels of heroin and its metabolites were modelled using a pharmacokinetic software. Next, heroin-seeking was assessed after 1 or 21 abstinence days. Between tests, rats underwent either forced or voluntary abstinence. The oestrous cycle was measured using a vaginal smear test. KEY RESULTS Intermittent access exacerbated heroin self-administration and was characterized by a burst-like intake, yielding higher brain peaks of heroin and 6-monoacetylmorphine concentrations. Moreover, intermittent access increased cue-induced heroin-seeking during early, but not late abstinence. Heroin-seeking was higher in females after intermittent, but not continuous access, and this effect was independent of the oestrous cycle. CONCLUSIONS AND IMPLICATIONS Intermittent heroin access in rats resembles critical features of heroin use disorder: a self-administration pattern characterized by repeated large doses of heroin and higher relapse vulnerability during early abstinence. This has significant implications for refining animal models of substance use disorder and for better understanding of the neuroadaptations responsible for this disorder. LINKED ARTICLES This article is part of a themed issue on Advances in Opioid Pharmacology at the Time of the Opioid Epidemic. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v180.7/issuetoc.
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Affiliation(s)
- Ginevra D'Ottavio
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Ingrid Reverte
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Davide Ragozzino
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Maria Meringolo
- Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Michele Stanislaw Milella
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Toxicology Unit, Policlinico Umberto I University Hospital, Rome, Italy
| | - Fernando Boix
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Marco Venniro
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aldo Badiani
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Sussex Addiction Research and Intervention Centre (SARIC) and School of Psychology, University of Sussex, Brighton, UK
| | - Daniele Caprioli
- Laboratory affiliated to Institute Pasteur Italia - Fondazione Cenci Bolognetti - Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
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Kleykamp BA, De Santis M, Dworkin RH, Huhn AS, Kampman KM, Montoya ID, Preston KL, Ramey T, Smith SM, Turk DC, Walsh R, Weiss RD, Strain EC. Craving and opioid use disorder: A scoping review. Drug Alcohol Depend 2019; 205:107639. [PMID: 31683241 DOI: 10.1016/j.drugalcdep.2019.107639] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/06/2019] [Accepted: 08/30/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The subjective experience of drug craving is a prominent and common clinical phenomenon for many individuals diagnosed with opioid use disorder (OUD), and could be a valuable clinical endpoint in medication development studies. The purpose of this scoping review is to provide an overview and critical analysis of opioid craving assessments located in the published literature examining OUD. METHOD Studies were identified through a search of PubMed, Embase, and PsychInfo databases and included for review if opioid craving was the focus and participants were diagnosed with or in treatment for OUD. RESULTS Fifteen opioid craving assessment instruments were identified across the 87 studies included for review. The most common were the Visual Analog Scale (VAS, 41 studies), Desires for Drug Questionnaire (DDQ, 12 studies), Heroin Craving Questionnaire (HCQ, 10 studies), and Obsessive-Compulsive Drug Use Scale (OCDUS, 10 studies). Craving assessments varied considerably in their format, content, time frame, and underlying subscales, and only 6 of 15 had been psychometrically evaluated. DISCUSSION This review identified a variety of opioid craving assessments, but few had been evaluated for their psychometric properties making it difficult to ascertain whether craving is being assessed optimally in studies of OUD. Thus, the development of a reliable and valid opioid craving assessment would be worthwhile and could be guided by recently published Food and Drug Administration Clinical Outcome Assessment (COA) guidelines. Importantly, a COA focused on opioid craving could be a valuable addition to research studies designed to evaluate novel treatments for OUD.
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Affiliation(s)
- Bethea A Kleykamp
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA.
| | | | - Robert H Dworkin
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA
| | - Andrew S Huhn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kyle M Kampman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kenzie L Preston
- Clinical Pharmacology and Therapeutics Research Branch, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Tanya Ramey
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Shannon M Smith
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA
| | - Dennis C Turk
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Robert Walsh
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Roger D Weiss
- McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Eric C Strain
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Mirzaian B, Heydari Fard J, Hoseini S. Cognitive performance and social support in patients under maintenance therapy. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2019. [DOI: 10.4103/jnms.jnms_8_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Shen W, Wang Q, Zhang J, Ping W, Zhang J, Ye W, Hu Q, Cerci D, Zhou W. A Retrospective Survey of Buprenorphine Substitute Treatment With Minimal Dosage in Heroin Use Disorder. Front Psychiatry 2019; 10:888. [PMID: 31866884 PMCID: PMC6904327 DOI: 10.3389/fpsyt.2019.00888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/11/2019] [Indexed: 01/14/2023] Open
Abstract
Objectives: It is widely accepted that buprenorphine maintenance treatment (BMT) with dosages above 8 mg daily is effective for patients with heroin use disorder. In this study, the authors evaluated the effectiveness of long-term BMT for heroin users in China, with dosages kept on a much smaller level. Methods: This is a retrospective observational study of 72 patients who had undergone detoxification and continued with buprenorphine maintenance between 2007 and 2016. Measurements such as self-reported relapse status, buprenorphine doses, protracted symptoms, general health condition, and self-reported side effects were included. Results: At the time of interview, 51 patients had remained abstinent at follow-up (including 13 who were opioid-free). The dosages of buprenorphine were 1.33 ± 0.88 (ranging 0.3-3.5) mg/day when maintenance treatment was initiated and 1.2 ± 0.8 (ranging 0.2-3.2) mg/day at the last follow-up. The remaining patients had either relapsed on heroin (n = 11) or switched to compulsory treatment (n=10). In general, abstinent patients had minimal protracted symptoms, especially in physical symptoms. Opioid-free abstainers were more likely to report good physical health than patients on buprenorphine. Predictors of worse outcomes (relapsed or switched to compulsory treatment) were lower education levels, younger age, and younger onset of illicit drug use. Conclusions: This study shows promising results of minimal-dosage BMT in treating heroin use disorder. We recommend further studies applying minimal-dosage BMT in China and worldwide.
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Affiliation(s)
- Wenwen Shen
- Ningbo Addiction Research and Treatment Center, Zhejiang Provincial Key Lab. of Addiction, Ningbo University School of Medicine, Ningbo, China
| | - Qing Wang
- Ningbo Addiction Research and Treatment Center, Zhejiang Provincial Key Lab. of Addiction, Ningbo University School of Medicine, Ningbo, China
| | - Jianbin Zhang
- Ningbo Addiction Research and Treatment Center, Zhejiang Provincial Key Lab. of Addiction, Ningbo University School of Medicine, Ningbo, China
| | - Wenkai Ping
- Ningbo University School of Medicine, Ningbo, China
| | - Jiawen Zhang
- Ningbo University School of Medicine, Ningbo, China
| | - Weiting Ye
- Ningbo University School of Medicine, Ningbo, China
| | - Qianyu Hu
- Ningbo University School of Medicine, Ningbo, China
| | - Deniz Cerci
- Vivantes Wenckebach-Klinikum, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Berlin, Germany
| | - Wenhua Zhou
- Ningbo Addiction Research and Treatment Center, Zhejiang Provincial Key Lab. of Addiction, Ningbo University School of Medicine, Ningbo, China.,Ningbo University School of Medicine, Ningbo, China
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Medication Treatments for Opioid Use Disorder: What Is the Impact on Mood and Mood Disorders? CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0215-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gayman C, Pietras C. Laboratory Measures of Aggression in Methadone Patients Pre- and Postdose. PSYCHOLOGICAL RECORD 2016. [DOI: 10.1007/s40732-016-0206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vogel M, Bucher P, Strasser J, Liechti ME, Krähenbühl S, Dürsteler KM. Similar and Different? Subjective Effects of Methylphenidate and Cocaine in Opioid-Maintained Patients. J Psychoactive Drugs 2016; 48:93-100. [DOI: 10.1080/02791072.2015.1130883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Acute effects of intravenous heroin on the hypothalamic-pituitary-adrenal axis response: a controlled trial. J Clin Psychopharmacol 2013; 33:193-8. [PMID: 23422375 DOI: 10.1097/jcp.0b013e31828393cb] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Heroin dependence is associated with a stressful environment and with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. The present study examined the acute effects of intravenous heroin versus placebo on the HPA axis response in heroin-dependent patients. Twenty-eight heroin-dependent patients in heroin-assisted treatment and 20 age- and sex-matched healthy participants were included in a controlled trial in which patients were twice administered heroin or saline in a crossover design, and healthy controls were only administered saline. The HPA axis response was measured by adrenocorticotropic hormone (ACTH) levels and by cortisol levels in serum and saliva before and 20 and 60 minutes after substance administration. Craving, withdrawal, and anxiety levels were measured before and 60 minutes after substance application. Plasma concentrations of heroin and its main metabolites were assessed using high-performance liquid chromatography. Heroin administration reduces craving, withdrawal, and anxiety levels and leads to significant decreases in ACTH and cortisol concentrations (P < 0.01). After heroin administration, cortisol concentrations did not differ from healthy controls, and ACTH levels were significantly lower (P < 0.01). In contrast, when patients receive saline, all hormone levels were significantly higher in patients than in healthy controls (P < 0.01). Heroin-dependent patients showed a normalized HPA axis response compared to healthy controls when they receive their regular heroin dose. These findings indicate that regular opioid administration protects addicts from stress and underscore the clinical significance of heroin-assisted treatment for heroin-dependent patients.
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Pharmacokinetic-pharmacodynamic modeling of mood and withdrawal symptoms in relation to plasma concentrations of methadone in patients undergoing methadone maintenance treatment. J Clin Psychopharmacol 2012; 32:666-71. [PMID: 22926601 DOI: 10.1097/jcp.0b013e3182664ecd] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aims of the present study were to characterize the relationship between plasma racemic methadone and its enantiomers' concentrations with respect to their pharmacodynamic effects and to investigate the influence of potential covariates on the pharmacodynamic parameters in patients on methadone maintenance treatment (MMT). Eighty-eight regular subjects at the Sheffield Care Trust Substance Misuse Services were studied. Samples of blood and urine were collected before the daily dose of methadone. Blood samples were taken up to 5 hours after dose. Total plasma concentrations of (RS)-methadone and total and unbound plasma concentrations of both enantiomers were measured by liquid chromatography-mass spectrometry. The Total Mood Disturbance Score (TMDS), the Objective Opioid Withdrawal Scale (OOWS), and the Subjective Opioid Withdrawal Scale (SOWS) were used as measures of mood and withdrawal. Population pharmacokinetic/pharmacodynamic analysis and subsequent multiple regression analysis were used to determine the factors influencing the pharmacodynamic effects of methadone. Significant decreases (P ≤ 0.04) were observed in the scores for the TMDS, SOWS, and OOWS for 5 hours after methadone dosage. The TMDS had returned to baseline by 10 hours after dose (P = 0.98), at which time the SOWS remained significantly below baseline (P = 0.001). Multiple regression analysis revealed that 33% of the overall variation in unbound (R)-methadone EC50 was explained by 3 variables, namely CYP3A activity (9%), age (16%), and sex (8%). Age also accounted for 8% and 9% of the variation in total (rac)- and (R)-methadone EC50. The present study has confirmed that the duration of mood change in the present study was shorter than the effect of methadone in stabilizing withdrawal symptoms. Thus, it is likely that a once-daily dose of methadone, albeit effective for preventing withdrawal, may not be sufficient to improve mood in some patients. Finally, it was established that CYP3A activity, years of dependent use, sex, and age are major determinants of methadone EC50 with respect to TMDS.
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Wang PW, Wu HC, Yen CN, Yeh YC, Chung KS, Chang HC, Yen CF. Change in Quality of Life and Its Predictors in Heroin Users Receiving Methadone Maintenance Treatment in Taiwan: An 18-Month Follow-Up Study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2012; 38:213-9. [DOI: 10.3109/00952990.2011.649222] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cation-selective exhaustive injection and sweeping micellar electrokinetic chromatography for the analysis of methadone and its metabolites in serum of heroin addicts. J Chromatogr A 2011; 1218:6832-7. [DOI: 10.1016/j.chroma.2011.07.086] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 07/25/2011] [Accepted: 07/26/2011] [Indexed: 11/18/2022]
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