Cue reactivity and opioid blockade in amphetamine dependence: A randomized, controlled fMRI study

Area of Science:

• Neuroscience
• Psychiatry
• Addiction Medicine

Background:

• Naltrexone, an opioid antagonist, may reduce relapse risk in amphetamine dependence.
• The underlying mechanisms of naltrexone's potential effects on amphetamine dependence are not fully understood.

Purpose of the Study:

• To investigate whether naltrexone can attenuate cue reactivity and craving in individuals with amphetamine dependence.
• To explore the neural correlates of cue reactivity in amphetamine dependence.

Main Methods:

• A randomized, placebo-controlled study involving 40 men with severe, intravenous amphetamine dependence.
• Participants underwent BOLD fMRI during exposure to drug-related and neutral stimuli, with subjective craving ratings.
• Twenty-nine participants provided data for final analysis.

Main Results:

• Drug-related stimuli triggered significant subjective craving and brain activations in the striatum, cingulate cortex, and visual attention networks.
• A longer history of amphetamine use correlated with increased prefrontal cortex activation.
• Naltrexone showed no significant effect on brain activations or subjective craving ratings compared to placebo.

Conclusions:

• Individuals with severe stimulant use disorder display robust neural cue reactivity, influenced by the duration of drug use.
• This study found no evidence that naltrexone impacts cue reactivity in this patient population.