Addicts' Craving Triggers Differ by Sex

Cravings in cocaine-dependent men appear to be triggered by drug cues while cravings in cocaine-dependent women appear to be triggered by stress, researchers at the Yale School of Medicine report in a study published online Jan. 31 in The American Journal of Psychiatry.

Marc Potenza, MD, PhD, professor of psychiatry, child study, and neurobiology at Yale, and colleagues performed functional magnetic resonance imaging (fMRI) on 30 abstinent cocaine-dependent individuals (16 women and 14 men) and 36 healthy recreational-drinking controls (18 women and 18 men). During the brain scans, subjects were presented with descriptions of situations or events that they found personally stressful as well as cues involving drugs or alcohol.

Among the cocaine-dependent subjects, increased corticostriatal-limbic activity was detected in areas of the brain associated with addiction and motivation, such as the striatum, insula, and anterior and posterior cingulate. However, the increased activity in the brains of cocaine-addicted women occurred during exposure to stressful scripts and in the brains of cocaine-addicted men during the drug and alcohol cues.

Potenza said that the findings suggest that cocaine-dependent women might benefit from stress-reduction therapy while cocaine dependent-men might benefit more from cognitive behavioral therapy or a 12-step program in the vein of Alcoholics Anonymous.