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Long-term patterns of heroin use and mental health: 11-Year follow-up of the Australian treatment outcome study
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
associated with fewer child INT at age 4.5 years and a reduction in child INT from 4.5 to 6 years. Conclusions: Thus, drug use and tobacco use, the strongest prenatal risks, may increase youths’ sensitivity to environmental cues (evidenced by increased morning cortisol). Whereas generally this sensitivity to environmental cues would translate into more problems in youth who would experience an environment consistent with the genetic and prenatal risk (i.e., parental SU), in this study children were adopted into generally positive environments. Thus, in this sample children exposed to drug and tobacco use may be able to take advantage of the generally positive environmental influences because of altered cortisol function. Financial support: R01HD042608, R01MH092118, F31DA033737 and T32DA016184. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.439 Long-term patterns of heroin use and mental health: 11-Year follow-up of the Australian treatment outcome study Christina Marel 1 , Maree Teesson 1 , Katherine Mills 1 , Shane Darke 1 , Joanne Ross 1 , Tim Slade 1 , Lucy Burns 1 , Michael Lynskey 2 1 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia 2 Washington University, St Louis, MO, United States
Aims: Heroin dependence is a chronic and in many cases, lifelong condition, associated with comorbid mental health disorders. Using data collected as part of the Australian Treatment Outcome Study, the present paper aims to examine the major findings of heroin use, comorbid disorders and treatment patterns over 10–11 years. Methods: 615 people with heroin dependence were recruited to the study in 2001–2002, and re-interviewed at 3-, 12-, 24-, 36months and 10–11 years post-baseline (follow-up rates of 89%, 81%, 76%, 70% and 69% at the time of writing). Heroin dependence was assessed at each time point using the Composite International Diagnostic Interview version 2.1, and heroin treatment since the last interview was obtained using the timeline follow-back method. Results: At 11-years, preliminary analyses indicate that over 14% of the cohort endorsed criteria for heroin dependence and 47% were in treatment for opiate dependence. One fifth of the cohort met criteria for current depression; 41% for current post traumatic stress disorder (PTSD); and 22% had committed at least one crime in the past month. The overwhelming majority of the cohort (98%) had experienced a period of abstinence in the follow-up period, with a median period of consecutive abstinence of 60 months (5 years). Overall, physical and mental health was poorer than population norms. Just over 10% of the cohort were deceased. Conclusions: Despite significant reductions in heroin use and dependence over the 11-year follow-up period, there were continued high rates of other comorbidities. Further, although a significant proportion of the cohort achieved continual abstinence for substantial portions of the follow-up period, preliminary findings highlight the importance for long-term treatment for this chronic debilitating condition. Financial support: The study was funded by the Australian National Health and Medical Research Council. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.440
e193
Cocaine-dependent subjects display attentional bias toward cocaine-related but not alcohol-related stimuli Katherine R. Marks 1,3 , William W. Stoops 1,3 , Craig R. Rush 1,2,3 1 Behavioral Science, University of Kentucky, Lexington, KY, United States 2 Psychiatry, University of Kentucky, Lexington, KY, United States 3 Psychology, University of Kentucky, Lexington, KY, United States
Aims: Cocaine dependence is characterized by heightened attentional bias towards cocaine related stimuli relative to neutral stimuli. One criticism of attentional bias measures is that cocaine users might be hypersensitive to all substance-related emotionally evocative stimuli and not specifically to cocaine-related stimuli. The aim of this study was to demonstrate that cocaine users display a larger attentional bias toward cocaine-related images than alcohol-related images. Methods: Twenty-five cocaine dependent humans completed this within-subjects study that used a modified visual probe task. In this task, substance-related and matched neutral images were presented side-by-side. The substance-related images depicted cocaine or alcohol cues. Eye-tracking technology measured time spent fixating on each image. Cocaine cue and alcohol cue attentional bias scores were calculated as the difference in fixation time between the specific substance-related (i.e., cocaine or alcohol) and matched neutral images. Data were analyzed with repeated measures ANOVA. Results: Subjects fixated on cocaine-related images significantly longer than matched neutral images but did not fixate on alcoholrelated images longer than matched neutral images. The magnitude of the cocaine cue attentional bias score was significantly larger than the alcohol cue attentional bias score. Conclusions: These data replicate previous findings showing that cocaine users display an attentional bias towards cocainerelated images. Importantly, these data demonstrate that cocaine cue attentional bias is not a result of a general hypersensitivity to substance-related emotionally evocative stimuli suggesting that cocaine cue attentional bias is the result of incentive salience produced by cocaine cue conditioning. Financial support: Supported by NIDA grant T32 DA035200 to CRR and KRM and from University of Kentucky to WWS and KRM. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.441 Dopamine D3 receptor availability: Sex differences and effects of chronic drug exposure Susan Martelle 1 , Susan H. Nader 1 , Paul W. Czoty 1 , William S. John 1 , Amy H. Newman 2 , Michael A. Nader 1 1
Physiology and Pharmacology, WFUSM, Winston Salem, NC, United States 2 Molecular Targets and Medications Discovery, NIDA-IRP, Baltimore, MD, United States Aims: Chronic cocaine (COC) and methamphetamine (MA) exposure can cause neuroadaptations in the dopamine system, especially the D2-like superfamily, including the D3 receptor (DRD3) subtype. However, most studies have utilized male subjects. Recently, we found sex differences in the relationship between D2-like receptors and vulnerability to cocaine selfadministration (SA). One aim of the present study was to determine
associated with fewer child INT at age 4.5 years and a reduction in child INT from 4.5 to 6 years. Conclusions: Thus, drug use and tobacco use, the strongest prenatal risks, may increase youths’ sensitivity to environmental cues (evidenced by increased morning cortisol). Whereas generally this sensitivity to environmental cues would translate into more problems in youth who would experience an environment consistent with the genetic and prenatal risk (i.e., parental SU), in this study children were adopted into generally positive environments. Thus, in this sample children exposed to drug and tobacco use may be able to take advantage of the generally positive environmental influences because of altered cortisol function. Financial support: R01HD042608, R01MH092118, F31DA033737 and T32DA016184. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.439 Long-term patterns of heroin use and mental health: 11-Year follow-up of the Australian treatment outcome study Christina Marel 1 , Maree Teesson 1 , Katherine Mills 1 , Shane Darke 1 , Joanne Ross 1 , Tim Slade 1 , Lucy Burns 1 , Michael Lynskey 2 1 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia 2 Washington University, St Louis, MO, United States
Aims: Heroin dependence is a chronic and in many cases, lifelong condition, associated with comorbid mental health disorders. Using data collected as part of the Australian Treatment Outcome Study, the present paper aims to examine the major findings of heroin use, comorbid disorders and treatment patterns over 10–11 years. Methods: 615 people with heroin dependence were recruited to the study in 2001–2002, and re-interviewed at 3-, 12-, 24-, 36months and 10–11 years post-baseline (follow-up rates of 89%, 81%, 76%, 70% and 69% at the time of writing). Heroin dependence was assessed at each time point using the Composite International Diagnostic Interview version 2.1, and heroin treatment since the last interview was obtained using the timeline follow-back method. Results: At 11-years, preliminary analyses indicate that over 14% of the cohort endorsed criteria for heroin dependence and 47% were in treatment for opiate dependence. One fifth of the cohort met criteria for current depression; 41% for current post traumatic stress disorder (PTSD); and 22% had committed at least one crime in the past month. The overwhelming majority of the cohort (98%) had experienced a period of abstinence in the follow-up period, with a median period of consecutive abstinence of 60 months (5 years). Overall, physical and mental health was poorer than population norms. Just over 10% of the cohort were deceased. Conclusions: Despite significant reductions in heroin use and dependence over the 11-year follow-up period, there were continued high rates of other comorbidities. Further, although a significant proportion of the cohort achieved continual abstinence for substantial portions of the follow-up period, preliminary findings highlight the importance for long-term treatment for this chronic debilitating condition. Financial support: The study was funded by the Australian National Health and Medical Research Council. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.440
e193
Cocaine-dependent subjects display attentional bias toward cocaine-related but not alcohol-related stimuli Katherine R. Marks 1,3 , William W. Stoops 1,3 , Craig R. Rush 1,2,3 1 Behavioral Science, University of Kentucky, Lexington, KY, United States 2 Psychiatry, University of Kentucky, Lexington, KY, United States 3 Psychology, University of Kentucky, Lexington, KY, United States
Aims: Cocaine dependence is characterized by heightened attentional bias towards cocaine related stimuli relative to neutral stimuli. One criticism of attentional bias measures is that cocaine users might be hypersensitive to all substance-related emotionally evocative stimuli and not specifically to cocaine-related stimuli. The aim of this study was to demonstrate that cocaine users display a larger attentional bias toward cocaine-related images than alcohol-related images. Methods: Twenty-five cocaine dependent humans completed this within-subjects study that used a modified visual probe task. In this task, substance-related and matched neutral images were presented side-by-side. The substance-related images depicted cocaine or alcohol cues. Eye-tracking technology measured time spent fixating on each image. Cocaine cue and alcohol cue attentional bias scores were calculated as the difference in fixation time between the specific substance-related (i.e., cocaine or alcohol) and matched neutral images. Data were analyzed with repeated measures ANOVA. Results: Subjects fixated on cocaine-related images significantly longer than matched neutral images but did not fixate on alcoholrelated images longer than matched neutral images. The magnitude of the cocaine cue attentional bias score was significantly larger than the alcohol cue attentional bias score. Conclusions: These data replicate previous findings showing that cocaine users display an attentional bias towards cocainerelated images. Importantly, these data demonstrate that cocaine cue attentional bias is not a result of a general hypersensitivity to substance-related emotionally evocative stimuli suggesting that cocaine cue attentional bias is the result of incentive salience produced by cocaine cue conditioning. Financial support: Supported by NIDA grant T32 DA035200 to CRR and KRM and from University of Kentucky to WWS and KRM. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.441 Dopamine D3 receptor availability: Sex differences and effects of chronic drug exposure Susan Martelle 1 , Susan H. Nader 1 , Paul W. Czoty 1 , William S. John 1 , Amy H. Newman 2 , Michael A. Nader 1 1
Physiology and Pharmacology, WFUSM, Winston Salem, NC, United States 2 Molecular Targets and Medications Discovery, NIDA-IRP, Baltimore, MD, United States Aims: Chronic cocaine (COC) and methamphetamine (MA) exposure can cause neuroadaptations in the dopamine system, especially the D2-like superfamily, including the D3 receptor (DRD3) subtype. However, most studies have utilized male subjects. Recently, we found sex differences in the relationship between D2-like receptors and vulnerability to cocaine selfadministration (SA). One aim of the present study was to determine