Cortisol, The Stress Hormone, May Inhibit Addiction-Related Memories And Reduce Cravings

Heroin
Heroin addiction causes severe cravings that can be as difficult to deal with as physical withdrawal symptoms. Shutterstock

Heroin is a drug with an especially high potential for addiction, a symptom of which is severe cravings. The stress hormone cortisol may have a diminishing effect on these cravings, according to a new study. Published in Translational Psychiatry, the research builds on previous work that focused on cortisol’s ability to diminish addiction memories — in other words, taking cortisol made the brain forget it was addicted.

Heroin—The Psychological Side Of Addiction

It’s well known that heroin, along with many other opioids, can produce powerful withdrawal symptoms, including nausea, body tremors, sweating, high temperatures, and changes in blood pressure.  These palpable symptoms are often what come to mind when we try to imagine the reasons why it is difficult for a heroin addict to quit.

There are also, powerful dependency symptoms that are physically invisible, the most notable of which is intense cravings. A craving isn’t a physical consequence of not having the drug; it is a strong memory of what using the drug feels like.

Heroin is a substance that causes a rush of endorphins in the brain and is much more powerful than any natural stimuli. When we recall an experience with heroin, the brain areas that are activated are the same ones that become active during the experience itself. It’s almost as if the memory is teasing the brain, creating a strong emotional response that evokes anticipation and longing. This results in a downward spiral of drug use, as the only thing that’s able to satisfy such a craving is heroin, with it’s intense artificial rush of euphoria.

Why Cortisol?

Cortisol is a glucocorticoid (steroid hormone) produced in the adrenal glands atop the kidney. Its effects are far reaching, but cortisol is known best for its role in “fight-or-flight” responses when we are faced with dangerous or stressful situations.

Past studies have linked the intake of glucocorticoids to a reduction in the brain’s ability to remember. This discovery could help patients suffering from anxiety disorders of PTSD by making it more difficult for them to recall episodes of panic or traumatic experiences.

The researchers involved in the latest study, from the University of Basel in Switzerland, hypothesized that the hormone would also have an inhibiting effect on addiction-related memories, and therefore aid in reducing addiction itself.

They gave 29 patients currently undergoing heroin-assisted treatment either a cortisol tablet or a placebo before receiving a dose of heroin. The patients who received cortisol reported, on average, a 25 percent decrease in cravings. This decrease, however, was seen only in patients who were dependent on lower doses of heroin, and not in those addicted to a higher dose.

It is unclear, however, whether this inhibitory effect on cravings will affect the day-to-day addictive behaviors of the patients. "For this reason, we want to examine whether cortisol can help patients reduce their heroin dosage or remain abstinent from heroin for longer," said Marc Walter, chief physician at the Psychiatric University Clinics (UPK) Basel, in a press release.

There are already plans in place for future research to determine if cortisol could also provide an inhibitory effect on cravings for nicotine, gambling, alcohol, and  other addictions.

Source: Walter M, Bentz D, Schicktanz N, Milnik A, Aerni A, Gerhards C, et al. Effects of cortisol administration on craving in heroin addicts. Translational Psychiatry. 2015.

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