The Influence of Oxytocin on the Mechanism of Opioid Craving

  • Research type

    Research Study

  • Full title

    Investigating the mechanism mediating the effects of oxytocin on opioid craving: A proof of concept study

  • IRAS ID

    281656

  • Contact name

    Christos Kouimtsidis

  • Contact email

    drckouimtsidis@hotmail.com

  • Sponsor organisation

    Surrey & Borders NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 11 months, 30 days

  • Research summary

    Summary of Research
    UK drug related deaths are at their highest since records began.There were 4,359 registered drug related deaths in 2018 and of these, 51% involved heroin. Drug users say that using drugs can feel automatic and uncontrollable which may be due to what happens in the brain when craving is triggered. This can lead to accidental overdose. It would be helpful if craving could be immediately reduced but currently we do not know enough about how craving works.

    Similar to how asthmatics use an inhaler when breathing becomes difficult, we believe it may be possible to use a nasal spray of oxytocin to reduce craving when it happens. Oxytocin is a non-addictive naturally produced hormone that helps manage the part of our brain which becomes over active when people crave but heroin users are unable to naturally regulate oxytocin.

    We will recruit 30 current heroin users on methadone or buprenorphine from drug treatment services and see them four times in total. Each visit lasts around an hour. We will pay for travel on each visit and give shopping vouchers on the last visit to thank them for taking part. We will show them a video of a man injecting heroin to trigger craving. People will be given oxytocin and placebo on 2 separate visits, asked to self report on cravings and take an attention test. Everyone will be given take home Naloxone, which reverses overdose, and interviewed on the last visit about their experience of craving. The study is confidential and anonymous.

    Results will be published in journals, presented at conferences, shared across social media and events where service users, professionals and public will be invited. This studies duration is 13 months and we hope to find evidence so we can run a bigger study for much longer in the future.

    Summary of Results
    Nasal oxytocin reduced cue-induced opioid craving versus placebo however statistical analysis showed we cannot rule out this happened by chance. The effect size, meaning how much the difference in craving score between oxytocin and placebo would relate to the real world, was low-moderate. This may because people struggled to identify changes in craving and is well known in people who use opioids.

    Nasal oxytocin versus placebo also appeared to impact the assessment of opioid related cues but again statistical analysis cannot rule out chance. The effect sizes, meaning how much the difference in self-reported likelihood to use heroin following exposure to the craving inducing cue between oxytocin and placebo would relate to the real world, were large. This is important and worthy of further investigation because if people assess themselves as less likely to use heroin when exposed to cues, it may help reduce opioid overdose and save lives.

  • REC name

    London - Brent Research Ethics Committee

  • REC reference

    20/LO/0758

  • Date of REC Opinion

    6 Jul 2020

  • REC opinion

    Further Information Favourable Opinion