Abstract
Opiates and cocaine both have effects on adrenal and gonadal function. Opiates suppress the hypothalamic-pituitary adrenal (HPA) axis, whereas cocaine leads to HPA activation. Opiates also cause gonadal dysfunction in both men and women. During withdrawal from opiates and cocaine, the HPA axis is activated which may reinforce relapse behavior. This review describes these hormonal effects and explores the potential consequences, including the effects on mood cognition and cardiovascular risk. Modification of the drug-induced hormonal dysfunction may represent a treatment strategy for drug rehabilitation.
Highlights
Opiates and cocaine are considered to be the main problem drugs of abuse worldwide[1]
In the United States, 2.3 million are current cocaine users and an estimated 119,000 abuse heroin according to a recent national survey[2]. Abuse of both of these drugs is associated with multiple poor health outcomes, reduced quality of life and criminal behavior
With the high prevalence of depression and anxiety symptoms among drug users, psychological dysfunction may be another mechanism by which the HPA axis is activated in drug users
Summary
Opiates and cocaine are considered to be the main problem drugs of abuse worldwide[1]. With the high prevalence of depression and anxiety symptoms among drug users, psychological dysfunction may be another mechanism by which the HPA axis is activated in drug users The consequences of this activation have not been fully explored, but these abnormalities may further contribute to metabolic alterations, leading to increased cardiovascular disease risk. The mechanism underlying these observations is unclear, but glucocorticoids appear to sensitize the mesolimbic system, such that the dopaminergic reward pathway is hyperstimulated upon re-exposure to the drug[41] Taken together, these experimental findings would suggest that HPA axis activation in cocaine and heroin abusers may lead to relapse behavior. The changes in gonadal and adrenal function to show promise as a potential drug treatment strategy, induced by opiates and cocaine use may have effects on it is unknown whether other pharmacologic quality of life, mood and cardiovascular risk.
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