Cited by 177Neurotransmitter Receptor Influence on BehaviorOpioid Use Disorder TreatmentSubstance Abuse Treatment and Outcomes

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Responsiveness to Drug Cues and Natural Rewards in Opiate Addiction: Associations With Later Heroin Use

Lubman, Dan I., Yücel, Murat, Kettle, Jonathan W. L., Scaffidi, Antonietta, MacKenzie, Trudi, Simmons, Julian G., Allen, Nicholas B.·2009·Archives of General Psychiatry

DOI 10.1001/archgenpsychiatry.2008.522

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Abstract

CONTEXT: Although drug cues reliably activate the brain's reward system, studies rarely examine how the processing of drug stimuli compares with natural reinforcers or relates to clinical outcomes. OBJECTIVES: To determine hedonic responses to natural and drug reinforcers in long-term heroin users and to examine the utility of these responses in predicting future heroin use. DESIGN: Prospective design examining experiential, expressive, reflex modulation, and cortical/attentional responses to opiate-related and affective stimuli. The opiate-dependent group was reassessed a median of 6 months after testing to determine their level of heroin use during the intervening period. SETTING: Community drug and alcohol services and a clinical research facility. PARTICIPANTS: Thirty-three opiate-dependent individuals (mean age, 31.6 years) with stabilized opiate-substitution pharmacotherapy and 19 sex- and age-matched healthy non-drug users (mean age, 30 years). MAIN OUTCOME MEASURES: Self-ratings, facial electromyography, startle-elicited postauricular reflex, and event-related potentials combined with measures of heroin use at baseline and follow-up. RESULTS: Relative to the control group, the opiate-dependent group rated pleasant pictures as less arousing and showed increased corrugator activity, less postauricular potentiation, and decreased startle-elicited P300 attenuation while viewing pleasant pictures. The opiate-dependent group rated the drug-related pictures as more pleasant and arousing, and demonstrated greater startle-elicited P300 attenuation while viewing them. Although a startle-elicited P300 amplitude response to pleasant (relative to drug-related) pictures significantly predicted regular (at least weekly) heroin use at follow-up, subjective valence ratings of pleasant pictures remained the superior predictor of use after controlling for baseline craving and heroin use. CONCLUSIONS: Heroin users demonstrated reduced responsiveness to natural reinforcers across a range of psychophysiological measures. Subjective rating of pleasant pictures robustly predicted future heroin use. Our findings highlight the importance of targeting anhedonic symptoms within clinical treatment settings.

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Authors: Lubman, D. I., Yücel, M., Kettle, J. W. L., Scaffidi, A., MacKenzie, T., Simmons, J. G., & Allen, N. B.
Affiliations: Orygen (AU)
The University of Melbourne (AU)
ORCID: Lubman, Dan I.
Yücel, Murat
Simmons, Julian G.
Allen, Nicholas B.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 2009-02-01
Volume: 66
Issue: 2
Pages: 205
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archgenpsychiatry.2008.522
OpenAlex: W2006014464
Cited by: 176
References: 55
Citations by year: 2026: 3 · 2025: 7 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 15 · 2020: 9 · 2019: 11 · 2018: 11 · 2017: 11 · 2016: 9 · 2015: 13 · 2014: 18 · 2013: 12 · 2012: 13
FWCI: 5.51
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: heroin addiction, opioid use disorder, drug cue reactivity, natural reward, hedonic response, anhedonia, P300, startle response, corrugator supercilii, facial electromyography, opioid substitution therapy, craving
MeSH terms: Adult, Affective Symptoms, Alcoholism, Arousal, Attention, Cerebral Cortex, Cues, Electromyography, Emotions, Female, Follow-Up Studies, Heroin Dependence, Humans, Male, Middle Aged, Motivation, Narcotics, Recurrence, Reward, Risk Factors, Reflex, Startle, Comorbidity, Event-Related Potentials, P300, Young Adult

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Responsiveness to Drug Cues and Natural Rewards in Opiate Addiction: Associations With Later Heroin Use

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