How do Stress and Craving Lead to Relapse in Opioid Use Disorder? Determining Sensitization Effects in the Locus Coeruleus Norepinephrine System in Humans

Abstract

Craving and stress promote opioid reuse during opioid use disorder (OUD) treatment, but a complete understanding of this relationship is lacking. The locus coeruleus norepinephrine (LC-NE) system is a key preclinical pathway linking stress and craving to opioid reuse. The LC-NE can be imaged in humans using high-resolution neuromelanin-sensitive MRI, a noninvasive proxy of LC-NE function and integrity. Inter-individual differences in this measure may reveal sensitization of LC which contributes to stress and craving, leading to opioid reuse. Aims: 1) Examine within-person relationships between stress, craving, and opioid use patterns serially and longitudinally in OUD; 2) Test for moderation of these patterns by LC-NE neuromelanin (between-person).