Cerebral blood flow effects of acute intravenous heroin administration

Kosel, Markus; Noss, Roger S.; Hämmig, Robert; Wielepp, Peter; Bundeli, Petra; Heidbreder, Rebeca; Kinser, J; Brenneisen, Rudolf; Fisch, Hans-Ulrich; Kayser, Sarah; Schläepfer, Thomas E.

doi:10.1016/j.euroneuro.2007.11.007

Cited by 22 publications

(15 citation statements)

References 32 publications

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“…32 The clinical consequences of this heroin effect on the HPA axis have not been clear. However, it has been suggested thatVin contrast to increased dopamine and opioid peptide functionVincreased corticotropin-releasing factor and cortisol levels are associated with negative effects and stress likestates in drug users.…”

Section: Discussionmentioning

confidence: 99%

Acute Effects of Intravenous Heroin on the Hypothalamic-Pituitary-Adrenal Axis Response

Walter¹,

Gerber²,

Kuhl³

et al. 2013

Journal of Clinical Psychopharmacology

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Heroin dependence is associated with a stressful environment and with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. The present study examined the acute effects of intravenous heroin versus placebo on the HPA axis response in heroin-dependent patients. Twenty-eight heroin-dependent patients in heroin-assisted treatment and 20 age- and sex-matched healthy participants were included in a controlled trial in which patients were twice administered heroin or saline in a crossover design, and healthy controls were only administered saline. The HPA axis response was measured by adrenocorticotropic hormone (ACTH) levels and by cortisol levels in serum and saliva before and 20 and 60 minutes after substance administration. Craving, withdrawal, and anxiety levels were measured before and 60 minutes after substance application. Plasma concentrations of heroin and its main metabolites were assessed using high-performance liquid chromatography. Heroin administration reduces craving, withdrawal, and anxiety levels and leads to significant decreases in ACTH and cortisol concentrations (P < 0.01). After heroin administration, cortisol concentrations did not differ from healthy controls, and ACTH levels were significantly lower (P < 0.01). In contrast, when patients receive saline, all hormone levels were significantly higher in patients than in healthy controls (P < 0.01). Heroin-dependent patients showed a normalized HPA axis response compared to healthy controls when they receive their regular heroin dose. These findings indicate that regular opioid administration protects addicts from stress and underscore the clinical significance of heroin-assisted treatment for heroin-dependent patients.

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Section: Discussionmentioning

confidence: 99%

Acute Effects of Intravenous Heroin on the Hypothalamic-Pituitary-Adrenal Axis Response

Walter¹,

Gerber²,

Kuhl³

et al. 2013

Journal of Clinical Psychopharmacology

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“…However, although acute heroin injection induced DA release in rats, 26 several imaging studies in humans failed to detected striatal DA release induced by acute heroin administration 55, 56, 57 or by the expectation of heroin reward. 58 This can either be explained by the small patient samples used in these studies, the limited sensitivity of the applied technologies or because activation of the dopaminergic system is not necessarily critical for the rewarding effects of heroin.…”

Section: Discussionmentioning

confidence: 99%

Increased functional connectivity in the resting-state basal ganglia network after acute heroin substitution

et al. 2015

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Reinforcement signals in the striatum are known to be crucial for mediating the subjective rewarding effects of acute drug intake. It is proposed that these effects may be more involved in early phases of drug addiction, whereas negative reinforcement effects may occur more in later stages of the illness. This study used resting-state functional magnetic resonance imaging to explore whether acute heroin substitution also induced positive reinforcement effects in striatal brain regions of protracted heroin-maintained patients. Using independent component analysis and a dual regression approach, we compared resting-state functional connectivity (rsFC) strengths within the basal ganglia/limbic network across a group of heroin-dependent patients receiving both an acute infusion of heroin and placebo and 20 healthy subjects who received placebo only. Subsequent correlation analyses were performed to test whether the rsFC strength under heroin exposure correlated with the subjective rewarding effect and with plasma concentrations of heroin and its main metabolites morphine. Relative to the placebo treatment in patients, heroin significantly increased rsFC of the left putamen within the basal ganglia/limbic network, the extent of which correlated positively with patients' feelings of rush and with the plasma level of morphine. Furthermore, healthy controls revealed increased rsFC of the posterior cingulate cortex/precuneus in this network relative to the placebo treatment in patients. Our results indicate that acute heroin substitution induces a subjective rewarding effect via increased striatal connectivity in heroin-dependent patients, suggesting that positive reinforcement effects in the striatum still occur after protracted maintenance therapy.

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“…These data are in line with findings in cocaine and alcohol dependence. Kosel et al (2008) examined acute effects of intravenous diacetylmorphine (heroin) administration. The results indicate that the cerebellum is an important component in functional brain systems subserving sensory and motor integration, learning, modulation of affect, motivation, and social behavior, which all play important roles in reinforcing properties of opioids.…”

Section: Heroinmentioning

confidence: 99%

Imaging Cognitive Deficits in Drug Abuse

Lundqvist

2009

Behavioral Neuroscience of Drug Addiction

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The neuropsychological network is a complex structure. To identify processes location and network capacity the brain imaging techniques together and in combination with other neuropsychological techniques and the expanding of well elaborated designs provide us with a multidimensional understanding, and contributes to the understanding of each illicit drug's character, which is of importance in designing of new treatment programs and clinical practice. Cannabis, MDMA, amphetamine, cocaine, and heroin abusers display both acute effects and chronic effects, deficits in attention, memory, and executive functioning. These deficits may last beyond the period of intoxication and cumulate with years of use. Cannabis users may recruit an alternative neural network as a compensatory mechanism during performance of tasks of attention. There is some evidence indicating the detrimental effects of cannabis on the maturing adolescent brain. Stimulant dependence is characterized by a distributed alteration of functional activation. Attenuated anterior and posterior cingulate activation, reduced inferior frontal and dorsolateral prefrontal cortex activation, and altered posterior parietal activation point towards an inadequate demand-specific processing of information. On an individual level they exhibit process-related brain activation differences that are consistent with a shift from context-specific, effortful processing to more stereotyped, habitual response generation. Finally, opiate use appears to decrease the ability to shift cognitive set and inhibit inappropriate response tendencies.

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Cerebral blood flow effects of acute intravenous heroin administration

Cited by 22 publications

References 32 publications

Acute Effects of Intravenous Heroin on the Hypothalamic-Pituitary-Adrenal Axis Response

Acute Effects of Intravenous Heroin on the Hypothalamic-Pituitary-Adrenal Axis Response

Increased functional connectivity in the resting-state basal ganglia network after acute heroin substitution

Imaging Cognitive Deficits in Drug Abuse

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