A new study by Marshall University researchers Joan C. Edwards School of Medicine found that lower initial cortisol levels may serve as a predictor of retention in substance use disorder treatment programs.
The prospective observational study examined the salivary cortisol, stress exposure, childhood adverse experiences (ACEs), and treatment retention of men enrolled in abstinence-based residential alcohol and drug recovery programs. Their findings were published last month in Alcoholism: Clinical and Experimental Research, the scientific journal on alcohol abuse and treatment for the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism.
Cortisol levels reflect a physiological response to stress. In this case, researchers found that participants who stayed in the treatment program for less than 90 days had significantly higher initial cortisol levels than those who stayed in the program for more than 90 days. Furthermore, a Cox proportional risk model indicated that elevated salivary cortisol, marital/relationship status, and ACEs significantly correlated with the risks of early program withdrawal.
“Our hope is that these findings will lead to cortisol as a biomarker that can help clinicians determine which individuals need a more intensive therapeutic approach,” said Todd H. Davies, Ph.D., associate director of research and development at the Joan C. Edwards School of Medicine and corresponding author of the study.
Taylor R. Maddox-Rooper, Kristiana Sklioutouskaya-Lopez, Trenton Sturgill, Caroline Fresch, Charles W. Clements II, MD; Rajan Lamichhane, Ph.D.; and Richard Egleton, Ph.D., were also co-authors of the paper. The research team also partnered with Recovery Point of West Virginia, a long-term residential recovery program based on the peer-driven model of recovery.
The research team, in collaboration with Recovery Point, is currently working on a larger follow-up study that aims to identify clinically significant levels of cortisol. This comprehensive study also includes a more representative population and examines the hormone oxytocin.
This work is supported by a nationwide grant from the Marshall University Robert C. Byrd Center for Rural Health through the West Virginia Higher Education Policy Commission.
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