Fox Helen C, Talih Makram, Malison Robert, Anderson George M, Kreek Mary Jeanne, Sinha Rajita
Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, 06519, USA.
Psychoneuroendocrinology. 2005 Oct;30(9):880-91. doi: 10.1016/j.psyneuen.2005.05.002.
Stress is known to increase drug craving, associated physiological arousal and risk of relapse in drug dependent individuals. However, it is unclear whether these responses are altered by recent frequency of drug use. The current study examined whether frequency of cocaine and alcohol abuse alters drug craving and associated arousal with laboratory exposure to stress and to drug related cues.
Fifty-four recently abstinent treatment-seeking cocaine abusers who were part of a study on stress and drug craving were categorized into high- and low-frequency users on the basis of their recent cocaine use. The high use cocaine group also consumed significantly more alcohol than the low use cocaine group. Participants were exposed to a brief 5-min guided imagery procedure that involved imagining a recent personal stressful situation, a personal drug-related situation and a neutral-relaxing situation, one imagery session on separate days presented in random order. Subjective (craving and anxiety), cardiovascular (heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP)) and biochemical (adrenocorticotropic hormone (ACTH), cortisol, prolactin) measures were assessed.
High-frequency abusers demonstrated a significantly greater drug craving, anxiety and associated cardiovascular and hypothalamic-pituitary-adrenal (HPA) response to both stress and drug-cue exposure as compared to low-frequency abusers.
Increased frequency of recent cocaine and alcohol use is associated with an enhanced stress and cue-induced drug craving and arousal response that appears to be similar to the effects of cocaine, and one that may increase the vulnerability to drug-seeking behavior and relapse in drug dependent individuals.
已知压力会增加药物成瘾者对药物的渴望、相关的生理唤醒以及复发风险。然而，目前尚不清楚这些反应是否会因近期药物使用频率而改变。本研究探讨了可卡因和酒精滥用频率是否会改变药物渴望以及与实验室应激暴露和药物相关线索相关的唤醒反应。
54名近期寻求治疗的可卡因滥用者参与了一项关于压力和药物渴望的研究，根据他们近期的可卡因使用情况分为高频使用者和低频使用者。高频使用可卡因组的酒精摄入量也显著高于低频使用可卡因组。参与者接受了一个简短的5分钟引导性意象程序，该程序包括想象最近的个人压力情境、个人药物相关情境和中性放松情境，在不同的日子里以随机顺序进行一次意象训练。评估了主观（渴望和焦虑）、心血管（心率、收缩压（SBP）和舒张压（DBP））和生化（促肾上腺皮质激素（ACTH）、皮质醇、催乳素）指标。
与低频滥用者相比，高频滥用者在面对压力和药物线索暴露时，表现出明显更强的药物渴望、焦虑以及相关的心血管和下丘脑-垂体-肾上腺（HPA）反应。
近期可卡因和酒精使用频率的增加与压力和线索诱导的药物渴望及唤醒反应增强有关，这似乎与可卡因的作用相似，且可能增加药物依赖个体寻求药物行为和复发的易感性。
