Psychobiological responses to drug cues before and after methadone intake in heroin-dependent patients: A pilot study

Craving and stress frequently drive compulsive heroin use. Although methadone attenuates craving, drug-conditioned stimuli can trigger craving and possibly stress arousal in heroin-dependent patients receiving methadone maintenance. This study investigated drug cue-related craving, affectivity, and cortisol reactivity in 16 methadone-maintained patients before and after daily methadone. Unexpectedly, drug cues significantly increased craving after (t[15] = − 4.27, p = 0.001), but not before methadone intake. Patients displayed blunted cortisol response after post-methadone drug cues (t[15] = 3.05, p = 0.008) suggesting dissociated craving and cortisol reactivity after methadone intake of possible clinical relevance.