A new study by Marshall University researchers Joan C. Edwards School of Medicine has found that lower initial cortisol levels may serve as a predictor of retention in substance use disorder treatment programs.

The prospective observational study examined salivary cortisol, stress exposure, negative childhood experiences (ACE), and treatment retention of men enrolled in residential alcohol and drug recovery programs based on abstinence. Their findings were published last month in Alcoholism: clinical and experimental research, the scientific journal on alcohol abuse and treatment for the Alcoholism Research Society and the International Society for Biomedical Research in Alcoholism.

Cortisol levels reflect a physiological response to stress. In this case, the 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 longer than 90 days. Additionally, a Cox proportional hazards model indicated that elevated salivary cortisol, marital/relative status, and ACE score were significantly correlated with the odds of early program discontinuation.

“Our hope is that these findings will lead to cortisol as a biomarker that can help clinicians determine which people may need a more intensive therapeutic approach,” said Todd H. Davies, Ph.D., associate director of the 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 article. The research team also collaborated with Recovery Point of West Virginia, a long-term residential recovery program based on the peer-driven recovery model.

The research team, in conjunction with Recovery Point, currently has a larger follow-up study underway that aims to identify clinically significant levels of cortisol. This expanded study also includes a more representative population and examines the hormone oxytocin.

This work is supported by a rural grant from the Marshall University Robert C. Byrd Center for Rural Health through the West Virginia Higher Education Policy Commission.

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Material provided by Marshall University Joan C. Edwards School of Medicine. Note: Content may be edited for style and length.


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