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Salivary cortisol during opiate dependence and withdrawal
Author(s) -
Bearn J.,
Buntwal N.,
Papadopoulos A.,
Checkley S.
Publication year - 2001
Publication title -
addiction biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.445
H-Index - 78
eISSN - 1369-1600
pISSN - 1355-6215
DOI - 10.1080/13556210020040235
Subject(s) - polysubstance dependence , saliva , abstinence , medicine , morning , opiate , hydrocortisone , endocrinology , cortisol awakening response , drug withdrawal , glucocorticoid , psychology , psychiatry , substance abuse , drug , receptor
Abstract Seventeen inpatients (14 men, three women) with opiate dependence and polysubstance misuse participated in a longitudinal study of salivary cortisol secretion during and after lofexidine detoxification treatment. Both opiate withdrawal symptoms and salivary cortisol were measured every morning for up to 25 days. Results were compared with a control group of 10 normal volunteers. There was an 80% reduction in withdrawal symptom severity between the first 12 days and the subsequent 12 days of treatment. Salivary cortisol fell from a mean of 22.3 nm/l over days 1–12 to 18.5 nm/l during days 13–25, a reduction of 17%. Salivary cortisol concentration correlated significantly with withdrawal symptom severity. Salivary cortisol levels remained significantly higher than controls for the duration of the study. The study supports a role for hypothalamo–pituitary–adrenal (HPA) activation in opiate withdrawal. The contribution of persistant dysregulation of the HPA, found in this study, to the vulnerability for relapse after abstinence has been achieved, is discussed.