Triggers differ for addicted men, women

YALE (US) — The areas of the brain associated with craving have different triggers in cocaine-dependent men and women, a finding that suggests they may benefit from different treatment options.

A study published online in the American Journal of Psychiatry, shows addicted women’s brains are activated by stress—and men’s are activated by drug cues.

“There are differences in treatment outcomes for people with addictions who experience stress-induced drug cravings and those whose cravings are induced by drug cues,” says Marc Potenza, professor of psychiatry, child study, and neurobiology at Yale University and first author of the study. “It is important to understand the biologic mechanisms that underlie these cravings.”

Colored areas represent the relatively greater average activation of brain regions in cocaine–dependent subjects compared to control subjects who are social drinkers. The brain activation differences indicate a stronger response in women to stress cues, while in men a stronger difference occurs when they are presented cues relating to substance (drug) use. (Credit:Yale U.)


The researchers conducted functional magnetic resonance imaging scans of 30 cocaine-dependent individuals and 36 control subjects who were recreational drinkers. While undergoing brain scans, researchers then presented subjects with personalized cues (situations or events) the participants had indicated were personally stressful and other cues involving cocaine or alcohol.

As expected, cocaine-dependent individuals showed greater activation in broad regions of the brain linked to addiction and motivation than the control subjects. Patterns of activation between the groups, however, differed markedly in men and women when presented with stress or drug cues.

The findings suggest that women with cocaine dependence might benefit from stress-reduction therapies that specifically target these cravings. Men, on the other hand, might derive more benefit from elements of cognitive behavioral therapy or 12-step programs based on the principles of Alcoholics Anonymous.

The study was supported by the Yale Stress Center, Women’s Health Research at Yale, the Connecticut Department of Mental Health and Addiction Services, and grants from the National Institutes of Health and its Office of Research on Women’s Health.

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