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Brain dopamine response in human opioid addiction

Psychopharmacology Unit, University of Bristol, Bristol, and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

Tim M. Williams, MBChB,MRCPsych

Psychopharmacology Unit, University of Bristol, and Bristol Specialist Drug Service, Bristol, and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

Sue J. Wilson, PhD

Psychopharmacology Unit, University of Bristol, Bristol, UK

Lindsay G. Taylor, MSc

Psychopharmacology Unit, University of Bristol, Bristol, and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

Chin B. Eap, PhD

Unit of Biochemistry and Clinical Psychopharmacology, Centre for Psychiatric Neurosciences, Hospital of Cery, Prilly, Switzerland

Marc Augsburger, PhD and Christian Giroud, PhD

Laboratory of Forensic Toxicology and Chemistry, Institute of Forensic Medicine, CHUV, Lausanne, Switzerland

David J. Brooks, MD, DSc, FRCP, FMedSci

MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

Judy S. Myles, MBBCh, BAO, FRCPsych

Bristol Specialist Drug Service, Stokes Croft, Bristol, UK

Paul Grasby, BSc, MBBS, DCH, MRCPsych, MD, FRCP, FMedSci

MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

Anne R. Lingford-Hughes, MA, PhD, BMBCh, MRCPsych

Psychopharmacology Unit, University of Bristol, Bristol, and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK

David J. Nutt, DM, FRCP, FRCPsych, FMedSci

Psychopharmacology Unit, University of Bristol, Bristol, UK

Correspondence: Professor David J. Nutt, Psychopharmacology Unit, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol BS1 3NY, UK. Email: david.j.nutt{at}bristol.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Drugs of dependence cause dopamine release in the rat striatum. Human neuroimaging studies have shown an increase in dopamine in the equivalent region in response to stimulants and other drugs.

Aims

We tested whether opioids provoke dopamine release and its relationship to the subjective experience.

Method

In two combined studies 14 heroin addicts on methadone maintenance treatment underwent two positron emission tomography brain scans of the dopamine system using [¹¹C]-raclopride following an injection of placebo and either 50 mg intravenous diamorphine or 10 mg subcutaneous hydromorphone in a double-blind, random order design.

Results

Both opioids produced marked subjective and physiological effects, but no measurable change in [¹¹C]-raclopride binding.

Conclusions

The absence of a dopamine response to opioid agonists contrasts with that found with stimulant drugs and suggests dopamine may not play the same role in addiction to opioids. This questions the role of dopamine in the subjective experience of heroin in opioid addicts.

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