, Volume 200, Issue 4, pp 475–486 | Cite as

Brain mu-opioid receptor binding: relationship to relapse to cocaine use after monitored abstinence

  • David A. GorelickEmail author
  • Yu Kyeong Kim
  • Badreddine Bencherif
  • Susan J. Boyd
  • Richard Nelson
  • Marc L. Copersino
  • Robert F. Dannals
  • J. James Frost
Original Investigation



Cocaine users have increased regional brain mu-opioid receptor (mOR) binding which correlates with cocaine craving. The relationship of mOR binding to relapse is unknown.


To evaluate regional brain mOR binding as a predictor of relapse to cocaine use is the objective of the study.

Materials and methods

Fifteen nontreatment-seeking, adult cocaine users were housed on a closed research ward for 12 weeks of monitored abstinence and then followed for up to 1 year after discharge. Regional brain mOR binding was measured after 1 and 12 weeks using positron emission tomography (PET) with [11C]carfentanil (a selective mOR agonist). Time to first cocaine use (lapse) and to first two consecutive days of cocaine use (relapse) after discharge was based on self-report and urine toxicology.


A shorter interval before relapse was associated with increased mOR binding in frontal and temporal cortical regions at 1 and 12 weeks of abstinence (Ps < 0.001) and with a lesser decrease in binding between 1 and 12 weeks (Ps < 0.0008). There were significant positive correlations between mOR binding at 12 weeks and percent days of cocaine use during first month after relapse (Ps < 0.002). In multiple linear regression analysis, mOR binding contributed significantly to the prediction of time to relapse (R 2 = 0.79, P < 0.001), even after accounting for clinical variables.


Increased brain mOR binding in frontal and temporal cortical regions is a significant independent predictor of time to relapse to cocaine use, suggesting an important role for the brain endogenous opioid system in cocaine addiction.


Cocaine Mu-opioid receptor Positron emission tomography Relapse Carfentanil Frontal cortex Temporal cortex 



This work was supported by the Intramural Research Program of the National Institutes of Health, National Institute on Drug Abuse and NIH grant RO1 DA-09479 to JJF.

Financial Disclosures

The authors have no competing financial interests to declare.


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Copyright information

© US Government 2008

Authors and Affiliations

  • David A. Gorelick
    • 1
    • 3
    Email author
  • Yu Kyeong Kim
    • 2
    • 4
  • Badreddine Bencherif
    • 2
    • 5
  • Susan J. Boyd
    • 1
    • 6
  • Richard Nelson
    • 1
  • Marc L. Copersino
    • 1
    • 7
  • Robert F. Dannals
    • 2
  • J. James Frost
    • 2
  1. 1.Intramural Research Program, National Institute on Drug AbuseNational Institutes of HealthBaltimoreUSA
  2. 2.Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.NIDA IRPBaltimoreUSA
  4. 4.Department of Nuclear MedicineSeoul National UniversitySeoulSouth Korea
  5. 5.Department of RadiologyUniversity of Pittsburgh School of MedicinePittsburghUSA
  6. 6.Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreUSA
  7. 7.McLean HospitalHarvard UniversityBelmontUSA

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