Acupuncture inhibits cue-induced heroin craving and brain activation

Previous research using functional MRI has shown that specific brain regions associated with drug dependence and cue-elicited heroin craving are activated by environmental cues. Craving is an important trigger of heroin relapse, and acupuncture may inhibit craving. In this study, we performed functional MRI in heroin addicts and control subjects. We compared differences in brain activation between the two groups during heroin cue exposure, heroin cue exposure plus acupuncture at the Zusanli point （ST36） without twirling of the needle, and heroin cue exposure plus acupuncture at the Zusanli point with twirling of the needle. Heroin cue exposure elicited significant activation in craving-related brain regions mainly in the frontal lobes and callosal gyri. Acupuncture without twirling did not significantly affect the range of brain activation induced by heroin cue exposure, but significantly changed the extent of the activation in the heroin addicts group. Acupuncture at the Zusanli point with twirling of the needle significantly decreased both the range and extent of activation induced by heroin cue exposure compared with heroin cue exposure plus acupuncture without twirling of the needle. These experimental findings indicate that presentation of heroin cues can induce activation in craving-related brain regions, which are involved in reward, learning and memory, cognition and emotion. Acupuncture at the Zusanli point can rapidly suppress the activation of specific brain regions related to craving, supporting its potential as an intervention for drug craving.

Quality of Life in Heroin Users Attending Substitution Treatment: A Multicenter Study in Italy

Quality of life (QoL) is an important measure to verify the effectiveness of therapy in substance use disorders (SUD). In this cross-sectional, multicenter study QoL has been measured in 1057 heroin dependents attending SerDs (“Servizi per le Dipendenze”, Italian National Health System Services for Addictions) and has been correlated with demographic variables and drug treatment. QoL has been measured by using GHQ-12 (12-item General Health Questionnaire), a self-administered questionnaire whose value is inversely correlated with the QoL. The median value of GHQ-12 in the study population was 12 (interquartile range [IQ] 9 - 18): 640 patients (60.6%) scored 20 points at the GHQ-12, which relates with a bad QoL. Female population showed higher GHQ12 scores when compared to male population (14 [IQ 9 - 19] vs. 12 [IQ 9 - 17], p = 0.03). Similarly, unemployed patients showed higher GHQ12 scores when compared to employed patients (15 [IQ 10 - 20] vs. 12 [IQ 8 - 16], p 20. Results show that most of patients receiving care for heroin dependence at SerDs have a positive assessment of their quality of life, and that being unemployed and having a dual diagnosis are predictors of poor QoL. Besides, data suggest that assuming buprenorphine could be a protective factor for QoL.