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海洛因依赖个体阿片类药物消费的行为经济学分析:单价和会前药物供应的影响

Behavioral economic analysis of opioid consumption in heroin-dependent individuals: effects of unit price and pre-session drug supply.

作者信息

Greenwald Mark K, Hursh Steven R

机构信息

Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 2761 E. Jefferson Ave., Detroit, MI 48207, USA.

出版信息

Drug Alcohol Depend. 2006 Oct 15;85(1):35-48. doi: 10.1016/j.drugalcdep.2006.03.007. Epub 2006 Apr 17.

Abstract

Behavioral economic analysis has been used to investigate factors underlying drug consumption in laboratory animals and, increasingly, in human drug abusers. However, there are few studies in heroin abusers, especially those who are not in treatment; such studies may be valuable for understanding the mechanisms of persistent drug use. This study investigated effects of unit price (UP) and pre-session supply of hydromorphone (HYD) on choice and consumption of HYD. Heroin-dependent research volunteers (n=13) stabilized on buprenorphine 8 mg/day completed this eight-session inpatient study. In sessions 1-2, participants sampled two total HYD doses (12 and 24 mg IM) that could be earned in later sessions. In each of the final six sessions, volunteers were given access to a 12-trial choice progressive ratio schedule lasting 3h. On each trial, volunteers could earn a HYD unit dose (1 or 2 mg, for a maximum of 12 or 24 mg, respectively) or money (US dollars 2, for a maximum of US dollars 24). Fixed ratio requirements increased exponentially, generating 24 unit prices for behavioral economic analysis. Before some choice sessions, volunteers could choose (FR 1) to receive extra HYD (12 or 24 mg; at 0915), whereas on other days no supplement was available. HYD choice and peak responding (breakpoint, O(max)) measures increased with unit dose, decreased with pre-session supplements, and were greater among volunteers who used cocaine prior to the experiment. Taking pre-session supplements decreased P(max) and made group-percent HYD consumption more demand-elastic. Consumption was functionally equivalent at differing FR/unit dose combinations. Thus, opioid demand in heroin-dependent individuals not in treatment is a function of drug supply, unit price, and cocaine use.

摘要

行为经济学分析已被用于研究实验动物以及越来越多的人类药物滥用者的药物消费潜在因素。然而,针对海洛因滥用者的研究较少,尤其是那些未接受治疗的人;此类研究对于理解持续药物使用的机制可能具有重要价值。本研究调查了氢吗啡酮(HYD)的单价(UP)和会前供应量对HYD选择和消费的影响。13名依赖海洛因且每天服用8毫克丁丙诺啡稳定的研究志愿者完成了这项为期八节的住院研究。在第1 - 2节中,参与者对两种总量的HYD剂量(12毫克和24毫克肌肉注射)进行了采样,这些剂量可在后续节次中获得。在最后六节的每一节中,志愿者都要参与一个持续3小时的12次试验的选择渐进比率程序。在每次试验中,志愿者可以赚取一个HYD单位剂量(1毫克或2毫克,分别最多可赚取12毫克或24毫克)或金钱(2美元,最多可赚取24美元)。固定比率要求呈指数增长,为行为经济学分析生成了24种单价。在一些选择节次之前,志愿者可以选择(固定比率1)接受额外的HYD(12毫克或24毫克;在0915时),而在其他日子则没有补充剂量。HYD选择和峰值反应(断点,O(max))测量值随单位剂量增加,会前补充剂量时降低,并且在实验前使用过可卡因的志愿者中更高。接受会前补充剂量会降低P(max),并使HYD消费组百分比对需求更具弹性。在不同的固定比率/单位剂量组合下,消费功能等效。因此,未接受治疗的海洛因依赖个体的阿片类药物需求是药物供应、单价和可卡因使用的函数。

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