Stress Hormone Cortisol Could Reduce Heroin Cravings

Heroin cravings stress hormone
Cortisol, a hormone produced by the body when under stress, could be used to reduce cravings for heroin, according to a new study. Here, a heroin addict prepares heroin before using it in Lamu, November 21, 2014. Goran Tomasevic/Reuters

A stress hormone produced, for example, in response to exam situations could be used to treat cravings for heroin and other addictions, according to a new study.

Cortisol, which is secreted by the adrenal gland as part of the body's response to stressful situations, was found to decrease cravings in heroin patients by up to 25 percent, researchers from the University of Basel found.

The study, published in the medical journal Translational Psychiatry, involved administering either a cortisol tablet or placebo to heroin addicts undergoing treatment with pharmaceutical heroin (diacetylmorphine, which is legal for use in some countries, including the U.K.). The subjects were given the pill prior to receiving a dose of heroin and were later asked to rate their cravings using a subjective scale. Patients on a low dosage of heroinup to 305 milligrams per dayreported much lower cravings for another dose after taking the cortisol tablet compared to the placebo group. However, these results were not replicated with patients on a higher heroin dose.

According to the U.N. Office on Drugs and Crime (UNODC) World Drug Report 2014, as many as 22 million people worldwide are addicted to opiates, the family of drugs to which heroin belongs.

Dominique de Quervain, a cognitive neuroscientist at the University of Basel, says that the findings could have clinical implications for the treatment of other types of addiction. "It might be interesting to see if [cortisol] also works for other addictions for example, nicotine or gambling because they are all driven by craving," says de Quervain. "If cortisol helps to reduce craving in general, this of course may have clinical implications for other addictions."

Cortisol is commonly used as a medication in the form of hydrocortisone, in allergy treatments and as a treatment for rheumatic arthritis. Hydrocortisone works by blocking the release of inflammatory substances in the body.The drug is on the World Health Organisation's (WHO) list of essential medicines, which constitute the basic drugs required for a functional healthcare system.

Levels of cortisol in the body climb significantly under stressful conditions, such as before an exam. De Quervain and his colleagues hypothesised that, just as the stress of taking an exam can lead students to forget what they have learnt, increased cortisol levels could have the effect of wiping a heroin user's "addiction memory."

"We observed previously that cortisol can reduce memory retrieval in healthy subjects," says de Quervain. "What we think is that cortisol, by reducing addiction memory, can actually also reduce craving."

He adds that clinical trials will be needed to assess the safety and efficacy of cortisol before it becomes widely available as a treatment for addiction.