Abstracts / Drug and Alcohol Dependence 146 (2015) e2–e33 e27

Alcohol dependence, gender, and cortisolresponse predict amygdala response pattern tofMRI stress task

Natasha E. Wright 1, Claudia B. Padula 4, Kristin E.Maple 1, Robert Anthenelli 2, Erik Nelson 3, KristaM. Lisdahl 1

1 Psychology, University of Wisconsin-Milwaukee,Milwaukee, WI, United States2 University of California San Diego, San Diego, CA,United States3 University of Cincinnati, Cincinnati, OH, UnitedStates4 VA Palo Alto Health Care System, Palo Alto, CA,United States

Aims: Lifetime prevalence rate of AD is 12.5% (Hasin et al.,2007). As a result of stress, neural dysfunction in frontolimbicregions including the amygdala has been noted in healthy individ-uals (Lovallo, 2012) and serves as a risk factor in AD (Koob & Kreek,2007). Gender moderates stress, with differences in stress responseto stress and alcohol cues (Seo et al., 2011). This study examines theeffects of AD and gender on stress response in the amygdala, andwhether cortisol functioning predicts amygdala response.

Methods: Data were collected from 10 abstinent AD (6 female)and 11 controls (6 female). Subjects participated in an fMRI stresstask based on the Trier Social Stress Task. Multiple regressions wererun to examine if AD group status, gender, or AD*gender predictedamygdala pattern of response (measured by area under the curve,AUC). Follow up analyses in AD were conducted to examine if corti-sol levels collected a year prior to the scan prospectively predictedamygdala activation.

Results: Controlling for gender and handedness, AD group pre-dicted left and right initial and total (ps < .001) amygdala activation.Gender differences in left amygdala also existed, with femalesexhibiting greater left initial and sustained (ps < .03) activity. Con-trolling for gender, increased cortisol stress response measureda year prior to the scan predicted increased left amygdala initialresponse (p < .05) and marginally predicted left sustained (p < .07),right initial and sustained (ps < .09) amygdala activation.

Conclusions: The current study found that AD predicted amyg-dala response in an fMRI stress task; the AD group showed elevatedamygdala activation. Gender predicted left amygdala activation,with females having increased activation. AD status did not interactwith gender. In AD, cortisol measured in a hormone challenge taska year prior to the scan predicted amygdala activation. Implicationswill be discussed.

Financial support: UC URC Interdisciplinary Grant PIs: Medina& Anthenelli 3R01DA030354 PI: Lisdahl.

http://dx.doi.org/10.1016/j.drugalcdep.2014.09.753

Different dynamic relationship between stressand illicit drug use from pregnancy topostpartum among drug-using women

Helen Wu 1, Emil Coman 2, Howard Tennen 3,James Grady 3

1 Psychiatry, U Conn Health Center, Farmington, CT,United States2 TRIPP Center, UConn Health Center, Farmington,CT, United States3 Community Medicine and Health Care, U ConnHealth Center, Farmington, CT, United States

Aims: To document dynamic changes in the relationshipbetween stress and illicit drug use from pre-pregnancy to post-partum

Methods: During a larger longitudinal (24-month) study ofwomen’s drug use, 49 women reported using drugs in the last 30days at baseline and became pregnant during the course of thestudy. Self-reported drug use and perceived stress were examinedat 4 months pre-pregnancy, during each trimester, and 6 monthspostpartum.

Results: Drug-using pregnant women reported a generaldecline in perceived stress from pre-pregnancy through preg-nancy, with varying levels of perceived stress from deliveryto 6 months postpartum. Drug use declined sharply from pre-pregnancy through the 3rd trimester, and then increased duringpostpartum. Dynamic coupling modeling revealed distinct tempo-ral relationships between perceived stress and drug use duringpregnancy from postpartum. During pregnancy, we observed areciprocal relationship between stress and drug use from 2 monthsprior to 2nd trimester but not in 3rd trimester. Postpartum,although drug use predicted subsequent changes in drug use,perceived stress did not predict subsequent drug use until 6 monthspostpartum.

Conclusions: Among drug using women, pregnancy appearsto change the dynamic between stress and drug use. This maypartially explain the inconsistent reports of relationship betweenstress and illicit drug use in pregnancy and postpartum among highrisk groups of women, depending on when the data are collected.

Financial support: This research was in part funded by theNational Institutes of Health, National Institute of Drug Abuse,R01DA020058 and K01DA021814 awarded to Zhao Helen Wu.

http://dx.doi.org/10.1016/j.drugalcdep.2014.09.754

Area-level attributes and program resources aspredictors of methadone dosage patterns

David Wutchiett, Jemima A. Frimpong, T. D’Aunno

Columbia University, New York, NY, United States

Aims: Organizational and client characteristics have beenshown to be associated with differences in methadone dosagesadministered by outpatient substance abuse treatment programs.However, there is a dearth of research on the role of area-levelattributes (county-level) in determining resource availability andtreatment practice. We examine the role of area-level demograph-ics, economic characteristics, program structural characteristicsand resources in determining patterns in methadone dosages.

Methods: Structural equation modeling is used to estimatecausal relationships between county characteristics and programresources, and the relationship between dosage and programresources and characteristics. Program data come from the 1990to 2011 National Drug Abuse Treatment System Survey (NDATSS),and includes a sample of 702 programs. Area-level data were col-

e28 Abstracts / Drug and Alcohol Dependence 146 (2015) e2–e33

lected from the American Community Survey and the Area HealthResources Files. Methadone dosage rates were measured by per-centage of patients receiving dosages below 40, 60 and 80 mg/day.

Results: County density and median income were positivelyassociated with methadone program income; median countyincome formed a positive relationship with expenditures perpatient, after controlling for program income and total patients.Patient methadone dosage levels were significantly related to acounty’s unemployment rate and median income. High countypopulation density is associated with lower methadone dosages.However, increased county unemployment rates and programincome were found to be associated with increased rates of patientsreceiving higher dosages, controlling for total number of clients.

Conclusions: Area-level attributes and program resources areimportant determinants of variation in program treatment prac-tices. The significant relationship between these factors andconcentrated racial and ethnic populations may be significantcontributors in predicting the likelihood of patients receiving rec-ommended dosage levels. Future studies should define causalpathways and specify the effects of area-level characteristics onprogram resources and treatment.

Financial support: KL2 TR000081, R01DA030459.

http://dx.doi.org/10.1016/j.drugalcdep.2014.09.755

Risk of starting to smoke tobacco cigarettes inthe United States: Estimates for foreign-born vs.U.S.-born young people, 2002–2009

Wei Xue, Catalina Lopez-Quintero, J.C. Anthony

Department of Epidemiology and Biostatistics,Michigan State University, East Lansing, MI, UnitedStates

Aims: In the USA, the risk of starting to smoke tobacco is foundto vary across US-born and foreign-born (FB) young people andacross family heritage subgroups. In this project, we aim to shednew light on how environmental influences might shape these vari-ations by taking into account elapsed time from immigration tosmoking onset.

Methods: Study estimates are based on U.S. National Surveysof Drug Use and Health (RDAS, 2002–2009), each with a nation-ally representative sample of non-institutionalized civilians age 12years and older (n > 50,000 each year), and IRB-approved comput-erized self-interviews on smoking, nativity, family heritage, andyears lived in the US. Weighted data with complex survey varianceestimation yield values reported below.

Results: Among US-born youths, an estimated 7.4% start tosmoke each year (95% CI = 7.2%, 7.6%). For FB youth living in theUS < 5 years, 5–10 years, and >10 years, the risk estimates showa pattern toward convergence with USB estimates: 4.2% (95%CI = 3.6%, 4.9%); 4.6% (3.8%, 5.5%); 6.9% (6%, 7.9%), respectively (testfor trend, p < 0.05). However, patterns vary by family heritage. Forexample, estimated risk of starting to smoke for foreign-born non-Hispanic Blacks is uniformly lower, irrespective of time in theUS. For some Asian-American subgroups, the risk estimates oftenexceed those of US-born youths.

Conclusions: The health of new US immigrants is an importanttopic, and this evidence discloses dynamic environmental influ-ences against a background of more stable family-genetic and homecountry risk determinants. We hope this line of research eventuallymight help to shape more appropriately targeted prevention andearly intervention programs for foreign-born young people, as wellas their US-born peers.

Financial support: NIDA T32DA021129 (WVX); MSU (CLQ);K05DA015799 (JCA).

http://dx.doi.org/10.1016/j.drugalcdep.2014.09.756

Temporal profile of fronto-striatal-limbicactivity during implicit decisions in drugdependence

Dorothy Yamamoto 1, Jeremy Reynolds 2,Theodore Krmpotich 1, Marie Banich 3,1, LaetitiaThompson 1, Jody Tanabe 1

1 University of Colorado Denver, Aurora, CO, UnitedStates2 University of Denver, Denver, CO, United States3 University of Colorado Boulder, Boulder, CO, UnitedStates

Aims: Substance dependence is associated with impaireddecision-making and altered fronto-striatal-limbic activity. Bothincreases and decreases in brain activity have been reported in drugusers compared to controls during decision-making. Inconsistentresults might be explained by group differences in the temporalprofile of the fMRI response. While prior studies have analyzeddata assuming a canonical hemodynamic response profile, a finiteimpulse response (FIR) model measures the fMRI signal at discretetime points without assuming any particular temporal profile. Wecompared brain activity during decision-making and feedback insubstance users and controls using two models: a canonical hemo-dynamic response function (HRF) and a FIR model.

Methods: 37 substance-dependent individuals (SDI) and 43controls performed an event-related decision-making task duringfMRI scanning. Brain activity was compared across group usingcanonical HRF and FIR models.

Results: SDI were impaired at decision-making compared tocontrols. The canonical model showed that SDI had increasedfronto-striatal-limbic activity during decisions and decreasedactivity during feedback. FIR analysis confirmed increased activityin SDI during decisions. However, “decreased” activity in SDI dur-ing feedback corresponded to a lower post-stimulus undershoot ofthe hemodynamic response.

Conclusions: Increased activity in fronto-striatal-limbic path-ways in SDI compared to controls is consistent with prior workfurther supporting the hypothesis that abnormalities in these cir-cuits underlie impaired decision-making. We demonstrate for thefirst time using a FIR analysis that “reduced” activity during feed-back may simply reflect the tail end of the response to decision,the post-stimulus undershoot, rather than an actual difference inresponse to feedback.

Financial support: National Institute of Drug Abuse DA024104and DA027748.

http://dx.doi.org/10.1016/j.drugalcdep.2014.09.757