• Andreas Heinz, Matthias Reimold, Jana Wrase, Derik Hermann, Bernhard Croissant, Götz Mundle, Bernhard M Dohmen, Dieter F Braus, Dieter H Braus, Gunter Schumann, Hans-Jürgen Machulla, Roland Bares, and Karl Mann.
• Department of Psychiatry, Charité University Medicine Berlin, Campus Charité Mitte, Berlin, Germany.
• Arch Gen Psychiat. 2005 Jan 1; 62 (1): 57-64.

BackgroundThe pleasant effects of food and alcohol intake are partially mediated by mu-opiate receptors in the ventral striatum, a central area of the brain reward system. Blockade of mu-opiate receptors with naltrexone reduces the relapse risk among some but not all alcoholic individuals.ObjectiveTo test the hypothesis that alcohol craving is pronounced among alcoholic individuals with a high availability of mu-opiate receptors in the brain reward system.DesignPatients and comparison sample. The availability of central mu-opiate receptors was measured in vivo with positron emission tomography (PET) and the radioligand carbon 11-labeled carfentanil in the ventral striatum and compared with the severity of alcohol craving as assessed by the Obsessive Compulsive Drinking Scale (OCDS).SettingHospitalized care.ParticipantsVolunteer sample of 25 male alcohol-dependent inpatients assessed after detoxification of whom 12 underwent PET again 5 weeks later. Control group of 10 healthy men.Main Outcome MeasuresAfter 1 to 3 weeks of abstinence, the availability of mu-opiate receptors in the ventral striatum, including the nucleus accumbens, was significantly elevated in alcoholic patients compared with healthy controls and remained elevated when 12 alcoholic patients had these levels measured 5 weeks later (P<.05 corrected for multiple testing). Higher availability of mu-opiate receptors in this brain area correlated significantly with the intensity of alcohol craving as assessed by the OCDS.ConclusionsAbstinent alcoholic patients displayed an increase in mu-opiate receptors in the ventral striatum, including the nucleus accumbens, which correlated with the severity of alcohol craving. These findings point to a neuronal correlate of alcohol urges.

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