Serum Cortisol Secretion During Heroin Abstinence Is Elevated Only Nocturnally

Abstract

Several studies indicate abnormalities in the hypothalamic-pituitary-adrenal axis (HPA) during acute opiate withdrawal, but protracted withdrawal has gotten less study. The current study further characterized the 24-hour time course of plasma cortisol levels in heroin-dependent individuals who were abstinent for 10-15 days, which is beyond the 5 days of acute withdrawal, compared to demographically matched healthy controls using samples collected every 3 hours over 24 hours and assessed with radioimmunoassay (RIA). The abstinent heroin-dependent participants had significantly higher plasma cortisol levels nocturnally suggesting a loss of diurnal variation in these heroin subjects.

Elevated plasma prolactin in abstinent methamphetamine-dependent subjects

“…These findings stand in contrast to reports of higher cortisol levels in recently abstinent abusers of alcohol, opioids, and cocaine (7; 15; 16; 17). In a study of cocaine-dependent subjects, afternoon cortisol levels were elevated early in treatment, then returned to a baseline, similar to values in a control group, by the third week of abstinence (7).…”

Inhibitory transmission in the bed nucleus of the stria terminalis in male and female mice following morphine withdrawal

“…Furthermore, others have found that repeated precipitated withdrawal engages stress mechanisms including activation of the hypothalamic‐pituitary‐adrenal (HPA) axis that are not observed with spontaneous withdrawal in “drug‐dependent” mice . Indeed, salivary and serum cortisol levels are elevated in humans experiencing opioid detoxification, as well as in protracted withdrawal . Collectively, these findings suggest that repeated precipitated withdrawal using naloxone can significantly affect both behavior and physiology compared with morphine alone.…”

Impaired Emotional-Like Behavior and Serotonergic Function During Protracted Abstinence from Chronic Morphine

“…Abnormal HPA axis activity has been reported in post-dependent heroin addicts (58, 59). Recent clinical studies have shown that HPA activity and anxiety, but not negative mood ratings, could be normalized by opiate maintenance treatment, suggesting that depressive-like symptoms and basal HPA axis are not necessarily associated during abstinence (60).…”