Constantinou, N.; (2007) Changes in inhibitory control and drug salience in response to stress: differences between opiate users, ex-users and non-users. Doctoral thesis , University of London.

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Abstract

Rationale: Whilst relapse to drug taking, even after a substantial period of abstinence, is common, laboratory-based research documenting precursors to relapse in humans is limited.;Objectives: The purpose of this literature review is to evaluate evidence from both animal and human studies on the effect of acute stressors on drug craving and relapse.;Method: Attempts at conceptualizing the definition of stress have been unsuccessful (Chrousos & Gold, 1992). For the purposes of this review, stress was broadly defined in line with Piazza & Le Moal (1998) as coerced exposure to environmental conditions or events that would normally be considered aversive enough to motivate avoidance. This review considered both physical and psychological stressors and is limited to opiate (specifically heroin and morphine) and psychostimulant drugs (e.g. cocaine, amphetamine) in animals, and alcohol, opiates, nicotine, and cocaine in humans.;Conclusions: Results from animal studies of acute stress and relapse are inconsistent. Human studies, despite providing more consistent findings, have a range of methodological limitations. A greater understanding of how stress precipitates relapse is likely to have a significant impact on the way clinical interventions are offered to substance misusing individuals.

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