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Heroin Addiction and Related Clinical Problems: 2022, 24, N5 (pages: 27 - 35)

Automated Responses to Opioid-Related Cues as a Dysregulated Allostatic Oxytocin Response: A Short Review

Houghton B.

Summary: Background: Opioid use disorders are complex and involve biological, psychological and socioeconomic influences with long lasting changes in the brain resulting from chronic opioid use. Some of these changes relate to reactivity to opioid-related cues which are central to the continuation of opioid use. As these changes take time to reset, risk of relapse is increased from reduced tolerance to opioids. There may be a system involved in the regulation of dopamine, stress and opioid systems which is often overlooked in the context of perpetuating opioid use disorders – the oxytocin system. Methods: A targeted short review of relevant literature supporting the idea that oxytocin dysregulation, as a complex interaction between neurobiology and the environment, drives automated responses to opioid-related cues. Results: Oxytocin has recently been conceptualised as allostatic and can become dysregulated through biological (e.g. chronic opioid use), psychological (e.g. early trauma, psychiatric disorders) and socioeconomic (e.g. social exclusion, social disparity) interactions. Dysregulation may be an indicator of allostatic overload and lead to automated responses to environmental cues. Preclinical studies show oxytocin can decrease intravenous administration of heroin in rats and oxytocin analogues can prevent reinstatement of opioid seeking behaviour in mice. Human studies of nasal oxytocin demonstrate mixed results largely due to heterogeneity in study design. Conclusions: Oxytocin adaptations and dysregulation are observed across multiple risk factors for opioid use disorders and are implicated in automated cue-response as a dysregulated allostatic function. Increasing understanding of how to manipulate oxytocin in the context of opioid use disorder warrants further investigation.