Gender differences in subjective stress and neuroendocrine response to a stress task among individuals with opioid dependence: A pilot study

• Published in: Addictive behaviors Vol. 92; pp. 148 - 154
• Main Authors: Gilmore, Amanda K., Guille, Constance, Baker, Nathaniel L., Brady, Kathleen T., Hahn, Christine K., Davis, Callah M., McCauley, Jenna L., Back, Sudie E.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-05-2019; Elsevier Science Ltd
• Subjects: Addictive behaviors; Adult; Cocaine; Comorbidity; Cortisol; Dependence; Dephydroepiandrostrone; Drug abuse; Drug addiction; Drug dependence; Female; Gender differences; Heart rate; Heart Rate - physiology; Heroin; Hormones; Humans; Hydrocortisone - metabolism; Hypothalamic-pituitary-adrenal axis; Hypothalamo-Hypophyseal System - metabolism; Hypothalamo-Hypophyseal System - physiopathology; Male; Men; Methadone; Narcotics; Opioid dependence; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - metabolism; Opioid-Related Disorders - physiopathology; Opioids; Overdose; Pilot Projects; Pituitary-Adrenal System - metabolism; Pituitary-Adrenal System - physiopathology; Public health; Saliva - metabolism; Sex differences; Sex Factors; Social interactions; Stress; Stress, Psychological - epidemiology; Stress, Psychological - metabolism; Stress, Psychological - physiopathology; Tobacco; Women; Heart rate; Opioid dependence; Gender differences; Cortisol; Stress; Dephydroepiandrostrone
• ISSN: 0306-4603; 1873-6327; 1873-6327
• DOI: 10.1016/j.addbeh.2018.12.022

Opioid dependence is a significant public health problem in the United States and the number of opioid overdose deaths among women has increased dramatically in comparison to men in the last few years. In this context, understanding the biological mechanisms underlying gender differences in vulnerability to opioid dependence is essential.
The current pilot study examined gender differences in subjective stress, heart rate (HR), and cortisol/dephydroepiandrosterone (DHEA) response to a laboratory stressor (Trier Social Stress Test; TSST) or a no-stress condition, and drug cue paradigm among men (n = 21) and women (n = 18) with opioid dependence.
Significant group (TSST vs. no stress) differences emerged in self-reported stress [F(1,35) = 23.8, p < .001], HR [F(1,31) = 12.3; p = .001] and cortisol (F1,34 = 5.0; p = .032) response, such that the TSST group was more reactive than the no-stress group. Women reported greater subjective stress [F(1,35) = 6.5, p <= .015] in response to the TSST compared to men. However, men evidenced marginally greater cortisol and DHEA responses to the TSST compared to women [F(1,34) = 2.7; p = .113 and F(1,31) = 3.4; p = .073, respectively].
Although women with opioid dependence reported greater subjective stress when exposed to a laboratory stress paradigm as compared to men, the neuroendocrine response was more robust in men. This pattern was similar to gender findings in men and women with cocaine and tobacco use disorders. The blunted cortisol combined with an increased subjective response among women may be a sign of HPA axis dysregulation which could increase vulnerability to relapse in women.
•Opioid dependence is a significant public health problem.•We examined gender differences in vulnerability to opioid dependence.•Women reported greater subjective stress to after a stress task than men.•Women evidenced a blunted cortisol response to a stress task compared to men.