Sex and drug differences in stress, craving and cortisol response to the trier social stress task

Baker, Nathaniel L.; Neelon, Brian; Ramakrishnan, Viswanathan; Brady, Kathleen T.; Gray, Kevin M.; Saladin, Michael E.; Back, Sudie E.; Flanagan, Julianne C.; Guille, Constance; McRae-Clark, Aimee  L

doi:10.1007/s00213-022-06163-z

Original Investigation
Published: 20 May 2022

Sex and drug differences in stress, craving and cortisol response to the trier social stress task

Nathaniel L. Baker ORCID: orcid.org/0000-0003-3313-1579¹,
Brian Neelon^1,2,
Viswanathan Ramakrishnan¹,
Kathleen T. Brady^2,3,
Kevin M. Gray³,
Michael E. Saladin^3,4,
Sudie E. Back^2,3,
Julianne C. Flanagan^2,3,
Constance Guille³ &
Aimee L McRae-Clark^2,3

Psychopharmacology (2022)Cite this article

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Abstract

Rationale

The hypothalamic–pituitary–adrenal (HPA) axis is a critical hormonal system involved in stress response. A number of studies have investigated the HPA axis response of drug-dependent individuals to stressors. Stress-induced vulnerabilities in the HPA axis may differ in response to chronic use of different substances, possibly leading to different target therapies. There has not been a direct comparison of HPA axis and subjective response between individuals with different types of substance use disorders following a laboratory stress intervention.

Objectives

The primary goal of the current study was to compare subjective and neuroendocrine response to the Trier Social Stress Task (TSST) across multiple primary types of substance use disorders and investigate differential response between males and females.

Methods

Four hundred participants were drawn from seven studies completed at the Medical University of South Carolina between 2011 and 2021. The TSST was utilized across studies and subjective and neuroendocrine responses measured following completion. Generalized linear mixed effects models and area under the response curve analysis were used to compare both substance type and sex differences.

Results

The study groups involving individuals with cocaine use disorder had blunted stress, craving and cortisol response following the TSST as compared to other substance use groups. Females in the cocaine groups reported higher subjective stress but lower cortisol than males.

Conclusions

The study results indicate that there may be differential effects of substances on the HPA axis, with cocaine using individuals exhibiting more blunting of the HPA axis response as compared to users of other substances.

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Funding

This study was funded by NIH Grants U54DA016511, P50DA016511, K23 DA021228, K12HD055885, and UL1RR029882.

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Authors and Affiliations

Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, 29425, USA
Nathaniel L. Baker, Brian Neelon & Viswanathan Ramakrishnan
Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
Brian Neelon, Kathleen T. Brady, Sudie E. Back, Julianne C. Flanagan & Aimee L McRae-Clark
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
Kathleen T. Brady, Kevin M. Gray, Michael E. Saladin, Sudie E. Back, Julianne C. Flanagan, Constance Guille & Aimee L McRae-Clark
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA
Michael E. Saladin

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Nathaniel L. Baker
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Brian Neelon
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Viswanathan Ramakrishnan
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Kathleen T. Brady
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Kevin M. Gray
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Michael E. Saladin
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Sudie E. Back
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Julianne C. Flanagan
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Constance Guille
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Aimee L McRae-Clark
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Correspondence to Nathaniel L. Baker.

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Baker, N.L., Neelon, B., Ramakrishnan, V. et al. Sex and drug differences in stress, craving and cortisol response to the trier social stress task. Psychopharmacology (2022). https://doi.org/10.1007/s00213-022-06163-z

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Received: 04 June 2021
Accepted: 10 May 2022
Published: 20 May 2022
DOI: https://doi.org/10.1007/s00213-022-06163-z

Keywords

Trier Social Stress Task
Stress
Craving
Cortisol
Cocaine
Opioids
Cannabis
Nicotine
Sex