Effects of Stress and Other Factors on Opiate Drug Choice.
Condition: Heroin Dependence; Opioid-Related Disorders
MeSH terms: Opioid-Related Disorders; Heroin Dependence
Study type: Observational

Summary: 
      The purpose is to study the extent to which stress and other factors, including money, the
      amount of drug available and the amount of work effort, affect drug choice.

      This study will assess whether exposure to yohimbine, a drug stressor, increases opioid
      craving- and -seeking behavior. We will determine whether these behavioral outcomes are
      associated with biobehavioral stress markers: increased saliva cortisol levels,
      cardiovascular response (heart rate and blood pressure), and negative mood state.
    

Detailed description: 
      Physical, environmental, and pharmacological stressors have been repeatedly shown to increase
      self-administration of various abused substances in both preclinical and human studies. The
      primary aim of the proposed work is to assess the effects of yohimbine, a pharmacological
      agent, used to create an objectively-measured stress response, upon opioid-seeking behavior
      and craving.

      Participants will first be an outpatient and must come to the Jefferson Avenue Research
      Program daily to receive buprenorphine doses. This phase will last at least 10 days or
      longer. Three times per week during the first two weeks (i.e., on 6 different days),
      participants will be asked to provide urine samples and to complete questionnaires that ask
      about opiate withdrawal symptoms.

      Next, participants will live on an inpatient research unit for at least 11 consecutive nights
      and possibly up to 15 consecutive nights. During this stay they will participate in a total
      of eight experimental sessions. Participants will take part in multiple trials in which they
      have the opportunity to choose drug, hydromorphone (HYD), or money. HYD is a drug that is
      currently used as a cough suppressant and to relieve pain. During the first two test
      sessions, participants will receive a sample of the drug doses that can be chosen. Before
      each of the final 6 test sessions begin, participants will be given a capsule containing
      either different doses of the drug yohimbine or a placebo (blank). Yohimbine is a drug that
      has been shown to produce a "stress"-like response in humans. Then participants will have 12
      opportunities to choose either drug or money by using a computer to earn choices. Respiration
      rate, oxygen saturation, heart rate, and blood pressure will be monitored throughout choice
      trials. Self-report questionnaires will be completed at different times during the study.

      After participants have completed the experimental procedures, they will again come to the
      Jefferson Ave. Research Program daily to receive buprenorphine doses. The dose of
      buprenorphine will be gradually decreased so that they will eventually be free from
      medication. This will take three weeks. We will administer questionnaires and collect urine
      samples three times each week to assess using illicit drugs.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Heroin dependent research volunteers
      
Biospecimen description: 
      Whole Blood
    
Keywords: Behavioral Economics; Drug self administration; Opioid