Chronic opioid treatment may raise risk of post-traumatic stress disorder, study finds

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Senior author Michael Fanselow said the research suggests that chronic opioid use increases susceptibility to developing anxiety disorders. Photo credit: Reed Hutchinson/UCLA

While opioids are often prescribed to treat people with trauma-related pain, a new UCLA-led study suggests doctors should use caution before prescribing the drug to those they believe may experience severe stress in the future, in order to reduce the risk the patient will develop PTSD.

In the study, researchers administered doses of the opioid morphine to a group of 22 mice for one week, then gave the mice relatively strong foot shocks. After the morphine wore off, the mice were given mild electric foot shocks. These mice showed a substantially longer “freezing response” than a second, control group of 24 mice that had not been given morphine. When mice recall a frightening memory, they freeze. Their heart rates and blood pressure go up, and the more frightening the memory, the more they freeze.

“While we are generally aware that drug use, such as that in the current opioid crisis, has many deleterious effects, our results suggest yet another effect — increased susceptibility to developing anxiety disorders,” said senior author Michael Fanselow, UCLA distinguished Staglin family professor of psychology and director of UCLA’s Staglin Family Music Festival Center for Brain and Behavioral Health. “As opioids are often prescribed to treat symptoms such as pain that may accompany trauma, caution may be needed because this may lead to a greater risk of developing PTSD, if exposed to further traumatic events, such as an accident, later on.”

“The foot shocks produced lasting fear and anxiety-like behaviors, such as freezing,” Fanselow said.

“Our data are the first to show a possible effect of opioids on future fear learning, suggesting that a person with a history of opioid use may become more susceptible to the negative effects of stress,” Fanselow said. “The ability of opioids to increase PTSD-like symptoms far outlasted the direct effects of the drug or withdrawal from the drug, suggesting the effect may continue even after opioid treatment has stopped.”

Fanselow’s view is if there is reason to believe a patient is likely to experience severe emotional stress after opioid treatment, then doctors should use caution about prescribing an opioid. If opioid use is medically called for, then the patient should be kept away from potentially stressful situations. So, for example, a soldier treated with opioids for pain should not be sent back into combat for a period of time, he said. The development of post-traumatic stress disorder requires some stressful experience after opioid use, he said.

The researchers also gave some of the mice morphine after the initial trauma had occurred but before exposing them to the second, mild stressor. They found that mice treated with morphine after the initial trauma did not show enhanced fear learning following exposure to the mild stressor. This finding suggests that chronic use of opioids before — but not after — a traumatic event occurs affects fear learning during subsequent stressful events.

The researchers concluded the mice given morphine were more susceptible to post-traumatic stress disorder than the control group of mice not given any opioids, and inferred that people with a history of using opioids are more susceptible to PTSD than the general population.

The study is published in Neuropsychopharmacology, an international scientific journal focusing on clinical and basic science research that advances understanding of the brain and behavior.

The research was funded by the National Institute on Drug Abuse and National Institute of Mental Health.

An opiate is a drug naturally derived from the opium poppy plant, such as heroin, morphine and codeine. Opioid is a broader term that includes opiates and any substance, natural or synthetic, that binds to the brain’s opioid receptors — which play a key role in controlling pain, rewards and addictive behaviors. Synthetic opioids include the prescription painkillers Vicodin and OxyContin, as well as fentanyl and methadone.

Substance abuse and PTSD often go hand-in-hand, Fanselow said, and people with PTSD often take drugs to self-medicate. Nearly 40% of people with PTSD also have a drug disorder.

Fanselow and colleagues reported last month that a traumatic brain injury causes changes in a brain region called the amygdala; and the brain processes fear differently after such an injury.

This article originally appeared in the UCLA Newsroom.

UCLA astronomer gets best look at first comet from outside our solar system

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The comet 2I/Borisov, as seen on Oct. 12 with NASA’s Hubble Space Telescope. Scientists believe the comet is from another solar system. Photo credit: NASA, ESA and David Jewitt/UCLA

David Jewitt, a UCLA professor of planetary science and astronomy, has captured the best and sharpest look at a comet from outside of our solar system that recently barged into our own. It is the first interstellar comet astronomers have observed.

Comet 2I/Borisov (the “I” stands for interstellar) is following a path around the sun at a blazing speed of approximately 110,000 miles per hour, or about as fast as Earth travels around the sun. Jewitt studied it on Oct. 12 using NASA’s Hubble Space Telescope, which captured images of the object when it was about 260 million miles away. He observed a central concentration of dust around the comet’s solid icy nucleus — the nucleus itself is too small to be seen by Hubble — with a 100,000-mile-long dust tail streaming behind.

Jewitt said it’s very different from another interstellar object, dubbed ‘Oumuamua, that a University of Hawaii astronomer observed in 2017 before it raced out of our solar system.

“‘Oumuamua looked like a bare rock, but Borisov is really active — more like a normal comet,” said Jewitt, who leads the Hubble team. “It’s a puzzle why these two are so different. There is so much dust on this thing we’ll have to work hard to dig out the nucleus.”

That work will involve sophisticated image processing to separate the light scattered from the nucleus from light scattered by dust.

► View a 2-second time lapse video of the comet

2I/Borisov and ‘Oumuamua are the first two objects that have traveled from outside of our solar system into ours that astronomers have observed, but that’s because scientists’ knowledge and equipment are much better now than they ever have been, and because they know how to find them. One study indicates there are thousands of such comets in our solar system at any given time, although most are too faint to be detected with current telescopes.

Until 2I/Borisov, every comet that astronomers have observed originated from one of two places. One is the Kuiper belt, a region at the periphery of our solar system, beyond Neptune, that Jewitt co-discovered in 1992. The other is the Oort Cloud, a very large spherical region approximately a light-year from the sun, which astronomers think contains hundreds of billions of comets.

2I/Borisov was initially detected on Aug. 30 by Gennady Borisov at the Crimean Astrophysical Observatory, when it was 300 million miles from the sun. Jewitt said its unusually fast speed — too fast for the sun’s gravity to keep it bound in an orbit — indicates that it came from another solar system and that it is on a long path en route back to its home solar system.

Because the comet was presumably forged in a distant solar system, the comet provides valuable clues about the chemical composition and structure of the system where it originated.

2I/Borisov will be visible in the southern sky for several months. It will make its closest approach to the sun on Dec. 7, when it will be twice as far from the sun as Earth is. By the middle of 2020, it will pass Jupiter on its way back into interstellar space, where it will drift for billions of years, Jewitt said.

Comets are icy bodies thought to be fragments left behind when planets form in the outer parts of planetary systems.

20 new moons for Saturn

In separate research that has not yet been published, Jewitt is part of a team that has identified 20 previously undiscovered moons of Saturn, for a new total of 82 moons. The revised figure gives Saturn more moons than Jupiter, which has 79.

The new objects are all small, typically a few miles in diameter, and were discovered using the Subaru telescope on Maunakea in Hawaii. They can be seen only using the world’s largest telescopes, Jewitt said.

The moons might have formed in the Kuiper belt, said Jewitt, a member of the National Academy of Sciences and a fellow of the American Association for the Advancement of Science and of the American Academy of Arts and Sciences.

The research team was headed by Scott Sheppard, a staff scientist at the Carnegie Institution for Science, and includes Jan Kleyna, a postdoctoral scholar at the University of Hawaii.

This article originally appeared in the UCLA Newsroom.

Minds Matter: Raising the Curtain on Depression and Anxiety

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Photo of Cleveland Cavaliers basketball player Kevin Love and UCLA College’s Clinical Psychology expert Michelle Craske.

Cleveland Cavaliers basketball player Kevin Love and UCLA College’s Clinical Psychology expert Michelle Craske.

UCLA students, community members and supporters joined Cleveland Cavaliers basketball player Kevin Love and UCLA College’s Clinical Psychology expert Michelle Craske for a standing-room only hybrid class and public lecture on Monday, August 19, for “Minds Matter: Raising the Curtain on Depression and Anxiety,” a free hour-long discussion on the causes of depression and anxiety, public stigma, and potential advances for the future. The series was the first in an ongoing exploration of brain health that will continue with additional events focusing on bullying, aging well, and other topics.

Love, an NBA Champion and five-time NBA All-Star for the Cleveland Cavaliers, has publicly discussed his struggle with panic attacks and anxiety and his decision to seek therapy, and has become a leading voice in mental health advocacy and founded the Kevin Love Fund in 2018 with the mission of inspiring people to live their healthiest lives while providing the tools to achieve physical and emotional well-being.

“Mental health isn’t just an athlete thing, it’s an issue that affects everyone in some way. The more we can normalize the conversation around mental health, the more we can do to help those that are struggling,” said Love. “My goal in sharing my personal experience is to connect with others who are going through something and keep this dialogue top of mind.”

Michelle G. Craske is a UCLA Professor of Psychology, Psychiatry and Biobehavioral Sciences, Director of the Anxiety and Depression Research Center, and Associate Director of the Staglin Family Music Center for Behavioral and Brain Health. Craske has published extensively in the area of fear, anxiety and depression.

“We need to work together to bring anxiety and depression out of the dark. People who suffer will only seek help when they can do so without fear of shame. Event series such as ‘Minds Matter’ aim to shed a light on these critical issues, and to help make a positive breakthrough,” said Craske.

Craske also is Director of the Innovative Treatment Network within the UCLA Depression Grand Challenge, a campus-wide effort to cut the global burden of depression in half. The innovative treatment component, which Craske leads, seeks to develop novel and more effective treatments for depression and anxiety and increase the scalability and accessibility of existing evidence-based treatments.

The “Minds Matter” series leverages the strengths of UCLA College’s Psychology faculty as well as high-profile guests who provide specialized insight about the discussion topic. Upcoming sessions will include discussions on addiction, adolescent brain development and behavior, bullying, healthy aging, and thriving under stress. The “Minds Matter” series is made possible through the longstanding UCLA College and Geffen Playhouse partnership and the generous support of donors.

Check back for information on future “Minds Matter” events at  https://www.college.ucla.edu/seniorsurvey/minds-matter/.