Health & Medicine

Opioid use disorder might lead to ‘sticky’ brains

Individuals with opioid use disorder were less able to flexibly engage different patterns of brain activity, Yale researchers found.

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Illustration of a person in a hallway choosing between two images of brains

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Opioid use disorder might lead to ‘sticky’ brains
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Individuals with opioid use disorder can get “stuck” in particular patterns of brain activity, a new Yale study finds. And this stickiness is more pronounced after they’ve seen images related to opioids.

The findings, published Jan. 17 in JAMA Network Open, shed light on the neural mechanisms relevant to substance use, researchers say, and may have implications for treatments that aid in recovery.

Opioid use disorder is a chronic condition that continues to affect millions of people in the United States and around the world. A better understanding of what happens in the brain after opioid use could reveal more effective strategies for treatment. For the new study, Yale researchers assessed how well individuals with opioid use disorder were able to flexibly engage and switch between different patterns of brain activity.

“I’m interested in how people sometimes can’t stop thinking about things that might not be very helpful to them,” said Jean Ye, a Ph.D. student in neuroscience at Yale School of Medicine (YSM) and lead author of the study. “For this study, we wanted to explore that idea within individuals with opioid use disorder and how that might relate to cognitive control.”

Ye works in the labs of Elizabeth Goldfarb, an assistant professor of psychiatry, and Dustin Scheinost, an associate professor of radiology and biomedical imaging and senior author of the study.

Recurring patterns of brain activity are known as brain states and people can flexibly engage various brain states as their environments change or as they undertake different behaviors. 

For the study, Ye and her colleagues used functional magnetic resonance imaging (fMRI) to track individuals’ brain states while they rested and watched clips of movies. They found that participants with opioid use disorder were less flexible in engaging different brain states than those without the disorder. After viewing images related to opioids, such as photos of needles or pill bottles, individuals with opioid use disorder showed even less brain state flexibility than they did at rest.

Previous research has shown that substance use is linked to less cognitive control, which is the ability to direct one’s thoughts and behaviors. In the new study, the Yale researchers found that individuals who scored worse on measures of cognitive control also had less flexibility when it came to engaging different brain states after viewing images related to opioids.

“What we found suggests brain state flexibility and cognitive control may together play a role in some of the behaviors often associated with substance use, such as difficulty to suppress urges,” Ye said.

The participants in the study had all been prescribed the opioid use disorder treatment methadone. Researchers will be interested to see if brain state flexibility changes over time as patients are on treatment for longer periods, she said. 

“The findings may also point to new treatment strategies,” Ye added. “For instance, it will be worth studying whether a non-invasive brain stimulation like TMS [transcranial magnetic stimulation] could induce changes in how flexible one is in engaging different brain states.”