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Cortisol/DHEA-S Ratio Normalization by Buprenorphine

Associations with Stress, Coping, and Social Support in Youth with Opioid Use Disorder

Bibliographic Data

ID13912751
AuthorsManmeet Kaur (0000-0001-9843-2271, All India Institute of Medical Sciences), Manmeet Kaur Brar (0000-0003-0030-5077, All India Institute of Medical Sciences), Raka Jain (0000-0002-9239-0020, All India Institute of Medical Sciences, corresponding author), Roshan Bhad (0000-0003-4824-3346, All India Institute of Medical Sciences), Anju Dhawan (0000-0003-1402-5623, All India Institute of Medical Sciences), Rahul Raghav (0000-0001-8288-7992, All India Institute of Medical Sciences)
Year2025
Pages1-12
Publication date2025-09-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJournal of Psychoactive Drugs (JOURNAL)
Journal identifiersISSN: 0279-1072 • E-ISSN: 2159-9777
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/02791072.2025.2550288
PMID40891556
OpenAlexW4413931430
LanguageEN
References cited72

Opioid use disrupts the hypothalamic-pituitary-adrenal (HPA) axis, altering stress responses depending on the stage of use. A higher cortisol/DHEA-S ratio may indicate relapse risk in substance use disorders. This study aimed to explore differences in serum cortisol/DHEA-S ratio and its association with proximal and perceived stress, social support, and coping strategies in opioid-dependent youth. In this study, we assessed 51 males aged 15-24 with opioid (heroin) use disorder from an Indian treatment center, categorized into three groups: recently admitted patients with opioid use, buprenorphine-maintained patients, and healthy controls ( n = 17 each). Serum cortisol and DHEA-S levels were analyzed using ELISA. We found significant differences in cortisol ( p p p < .001) across groups. Recently admitted patients with opioid use had elevated cortisol/DHEA-S ratios (0.37), whereas buprenorphine maintenance with active coping strategies showed reduced ratios (0.22), indicating potential normalization of HPA axis function. Cortisol levels correlated positively with past-year stress in recent users, whereas the cortisol/DHEA-S ratio correlated negatively with social support. These findings suggest that buprenorphine maintenance, combined with effective coping and social support, may help normalize HPA axis imbalance, potentially reducing relapse risk in opioid-dependent youth. Further research is needed to confirm these findings and their implications for treatment strategies

Buprenorphine · Coping (psychology · Normalization (sociology · Opioid · Opioid use disorder · Psychiatry · Clinical Psychology · Heart Rate Variability and Autonomic Control · Medicine · Psychology · Stress Responses and Cortisol · Substance Abuse Treatment and Outcomes · Endocrinology · Internal Medicine

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Highly citedNo

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