Laboratory-induced cue reactivity among individuals with prescription opioid dependence

Abstract

Prescription opioid (PO) dependence is a critical health problem. Although examination of drug cue reactivity paradigms has advanced the understanding of risk factors for relapse for a variety of substances (e.g., cocaine, alcohol, nicotine), no PO specific drug cue paradigm has been developed. The current study addressed this gap in the literature and evaluated the ability of a newly developed PO drug cue paradigm to elicit subjective, physiological, and neuroendocrine changes among PO-dependent participants (n = 20) as compared to controls (n = 17). The drug cue paradigm included an induction script, viewing and handling paraphernalia (e.g., bottle of oxycontin pills, pill crusher) and watching a video depicting people using POs as well as places related to POs (e.g., pharmacies). Consistent with hypotheses, the PO group demonstrated significant pre- to post-cue increases on subjective ratings of craving, difficulty resisting POs, stress, and anger. The control group did not demonstrate significant changes on any of the subjective measures. Both the PO group and the control group evidenced significant pre- to post-cue increases in physiological responses (e.g., blood pressure, skin conductance), as expected given the arousing nature of the drug cue stimuli. The PO group, but not the control group, evidenced a significant pre- to post-cue increase in heart rate and salivary cortisol levels. The development and validation of a drug cue paradigm for POs may help inform future research and treatment development efforts for patients with PO dependence.

Keywords: Drug cue paradigm; Drug cue reactivity; Opiates; Prescription drugs; Prescription opioids.

Figure 1

Subjective stress response to the drug cue paradigm among individuals with prescription opioid dependence vs. controls. Note. Baseline = immediately pre drug cue paradigm. Immediate = immediately post drug cue paradigm.15 min, 30 min and 60 min = post drug cue paradigm.

Figure 2

Subjective craving response to the drug cue paradigm among individuals with prescription opioid dependence. Note. Baseline = immediately pre drug cue paradigm. Immediate = immediately post drug cue paradigm.15 min, 30 min and 60 min = post drug cue paradigm.

Figure 3

Cortisol response to the drug cue paradigm among individuals with prescription opioid dependence vs. controls. Note. Baseline = immediately pre drug cue paradigm. Immediate = immediately post drug cue paradigm.15 min, 30 min and 60 min = post drug cue paradigm.