City Research Online

Abstract

Opioid-related deaths are at record levels in the UK and contribute to over half of all drug-related deaths. Opioid use is complex and involves biological, psychological and socioeconomic influences which can trigger craving for opioids. Without craving management tools accidental overdose can occur from reduced tolerance and adulterants in supply. Solutions are urgently needed. The oxytocin system regulates dopamine, stress and reward systems but can become dysregulated through biological (e.g. chronic opioid use), psychological (e.g. psychiatric disorders, trauma) and socioeconomic (e.g. social exclusion, disparities) interactions. Emerging evidence suggests oxytocin could reduce craving.

This thesis considered the role of oxytocin in opioid use disorder and asked can a nasal spray of oxytocin reduce cue-induced craving at 7, 15 and 30 minutes post cue exposure?

The prevalence of psychiatric disorders in opioid-related deaths during 2006-2015 was analysed finding under diagnosis of psychiatric disorders in comparison to the general population when people were known to use illicit drugs. A systematic review of nasal oxytocin to reduce drug craving studies (n=17) then found heterogeneity and inconsistent methodological reporting. A randomized, double-blind crossover study (n=24) for nasal oxytocin (single dose, 40IU) to reduce cue-induced craving in males currently using heroin in addition to prescribed substitute opiates found no significant effect for oxytocin to reduce subjective craving (F = 0.73, df=1, p=0.79, η2=0.04) but did find a moderate effect size for oxytocin to reduce likelihood of using heroin following cue assessment (F = 2.83, df=1, p=0.10, η2=0.11). Finally the experience of participants (n=14) was explored supporting evidence of Alexithymia in self-identification of craving.

The findings were unable to reject the null hypothesis for nasal oxytocin to reduce cue-induced opioid craving. Theoretical arguments, quantitative and qualitative data supporting nasal oxytocin as being beneficial to reducing cue-induced opioid craving were put forward suggesting the need for further research.

Publication Type:	Thesis (Doctoral)
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RM Therapeutics. Pharmacology
Departments:	School of Health & Medical Sciences > Institute of Medical, Biomedical and Allied Health Education School of Health & Medical Sciences > School of Health & Medical Sciences Doctoral Theses Doctoral Theses

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