Ray Lara A, Miranda Robert, Kahler Christopher W, Leventhal Adam M, Monti Peter M, Swift Robert, Hutchison Kent E
Department of Psychology, University of Colorado at Boulder, Muenzinger Psychology Building, 345 UCB, Boulder, CO 80309-0345, USA.
Psychopharmacology (Berl). 2007 Sep;193(4):449-56. doi: 10.1007/s00213-007-0794-z. Epub 2007 May 6.
Although naltrexone has been widely researched in the context of drinking and smoking behaviors, with each substance studied separately, little is known about the effects of naltrexone on craving for cigarettes during alcohol intoxication.
The present study used a within-subjects double-blind placebo-controlled design to (1) examine the effects of alcohol, administered intravenously, on craving for cigarettes; (2) test the effects of naltrexone on cigarette craving during alcohol intoxication; and (3) examine the relationship between craving for alcohol and cigarettes across rising breath alcohol concentrations (BrACs).
Heavy drinking light smokers completed two counterbalanced intravenous alcohol challenge sessions, one after taking naltrexone (50 mg) for 3 days and one after taking a placebo for 3 days. During each session, participants reported on their craving for alcohol and cigarettes.
Analyses revealed a significant positive effect of BrAC on urge to smoke as well as a BrAC x Medication interaction. Specifically, the linear relationship between BrAC and urge to smoke was significantly weaker in the naltrexone condition, as compared to placebo. There was also a positive association between urge to drink and urge to smoke, and this relationship was moderated by BrAC.
These findings demonstrate that the pharmacological effects of alcohol alone induce craving for cigarettes and that naltrexone blunts the progression of craving for cigarettes during alcohol intoxication. These results highlight the potential clinical utility of naltrexone for heavy drinkers trying to quit smoking.
尽管纳曲酮在饮酒和吸烟行为方面已得到广泛研究，且对每种物质分别进行了研究，但对于纳曲酮在酒精中毒期间对烟瘾的影响知之甚少。
本研究采用受试者内双盲安慰剂对照设计，以（1）研究静脉注射酒精对烟瘾的影响；（2）测试纳曲酮在酒精中毒期间对烟瘾的影响；（3）研究随着呼气酒精浓度（BrACs）升高，对酒精和香烟的渴望之间的关系。
重度饮酒的轻度吸烟者完成了两次平衡的静脉酒精激发试验，一次是在服用纳曲酮（50毫克）3天后，另一次是在服用安慰剂3天后。在每次试验期间，参与者报告他们对酒精和香烟的渴望程度。
分析显示BrAC对吸烟冲动有显著的正向影响，以及BrAC与药物的交互作用。具体而言，与安慰剂相比，在纳曲酮条件下，BrAC与吸烟冲动之间的线性关系显著较弱。饮酒冲动和吸烟冲动之间也存在正相关，并且这种关系受BrAC调节。
这些发现表明，仅酒精的药理作用就会诱发对香烟的渴望，而纳曲酮可减轻酒精中毒期间对香烟渴望的进展。这些结果凸显了纳曲酮对试图戒烟的重度饮酒者的潜在临床效用。
