{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:46:38Z","timestamp":1760060798752,"version":"build-2065373602"},"reference-count":167,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Heroin addiction is associated with profound dysregulation of the endogenous opioid and stress response systems, yet current diagnostic frameworks may inadequately capture the traumatising aspects of this condition. This perspective proposes the concept of post-heroin post-traumatic stress spectrum (pH-PTSD\/S) as a clinical syndrome emerging from chronic opioid-induced neurobiological and psychosocial dysregulation, even in the absence of Criterion A trauma. Methods: The authors review evidence from neuroendocrinology, behavioural neuroscience, and clinical psychopathology to support a sensitisation-based model of trauma vulnerability in heroin use disorder (HUD). Results: Findings suggest that HUD patients frequently exhibit PTSD-spectrum symptoms, including hyperarousal, avoidance, emotional dysregulation, and altered stress reactivity. Opioid agonist treatment (OAT) may mitigate these symptoms by stabilising HPA axis function and reducing exposure to trauma-related contexts. The pH-PTSD\/S construct, measured through a dedicated instrument, identifies patients with subthreshold trauma-related symptoms and greater psychopathological burden. Conclusions: Heroin dependence may constitute a traumatising condition, requiring dimensional diagnostic tools and trauma-informed treatment strategies. Further research is needed to validate the nosological status of pH-PTSD\/S, clarify its distinction from protracted withdrawal or complex PTSD, and determine its implications for OAT duration and integrated care pathways.<\/jats:p>","DOI":"10.3390\/jcm14186662","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:08:03Z","timestamp":1758542883000},"page":"6662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-Heroin Post-Traumatic Stress Disorder Spectrum: Heroin Addiction as a Generator of Trauma Sensitisation in Everyday Life: A Perspective Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6324-0576","authenticated-orcid":false,"given":"Icro","family":"Maremmani","sequence":"first","affiliation":[{"name":"VP Dole Research Group, PISA-School of Addiction Medicine, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy"},{"name":"Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA"},{"name":"UniCamillus, International Medical University in Rome, Via di Sant\u2019Alessandro 8, 00131 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7935-3524","authenticated-orcid":false,"given":"Filippo","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"VP Dole Research Group, PISA-School of Addiction Medicine, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy"},{"name":"Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA"},{"name":"Addiction Unit, Department of Mental Health and Addictions, ASL5 Liguria NHS, Via Dalmazia 1, 19124 La Spezia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7457-6008","authenticated-orcid":false,"given":"Manuel Glauco","family":"Carbone","sequence":"additional","affiliation":[{"name":"VP Dole Research Group, PISA-School of Addiction Medicine, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy"},{"name":"Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA"},{"name":"Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-3705","authenticated-orcid":false,"given":"Angelo Giovanni Icro","family":"Maremmani","sequence":"additional","affiliation":[{"name":"VP Dole Research Group, PISA-School of Addiction Medicine, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy"},{"name":"Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA"},{"name":"UniCamillus, International Medical University in Rome, Via di Sant\u2019Alessandro 8, 00131 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209601","DOI":"10.1016\/j.josat.2024.209601","article-title":"Pharmacological treatments for co-occurring PTSD and substance use disorders: A systematic review","volume":"169","author":"Swannell","year":"2025","journal-title":"J. Subst. Use Addict. Treat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/S0277-9536(99)00399-8","article-title":"The experience of chronic illness and post-traumatic stress disorder: The consequences of cumulative adversity","volume":"50","author":"Alonzo","year":"2000","journal-title":"Soc. Sci. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1196\/annals.1441.030","article-title":"Chronic stress, drug use, and vulnerability to addiction","volume":"1141","author":"Sinha","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1176\/appi.ajp.162.8.1483","article-title":"Co-Occurring Mental and Substance Use Disorders: The Neurobiological Effects of Chronic Stress","volume":"162","author":"Brady","year":"2005","journal-title":"Am. J. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1176\/appi.ajp.158.8.1184","article-title":"Substance use disorders in patients with posttraumatic stress disorder: A review of the literature","volume":"158","author":"Jacobsen","year":"2001","journal-title":"Am. J. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.drugalcdep.2004.08.017","article-title":"Co-morbid post-traumatic stress disorder in a substance misusing clinical population","volume":"77","author":"Reynolds","year":"2005","journal-title":"Drug Alcohol. Depend."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1016\/j.addbeh.2006.02.007","article-title":"The association of substance use disorders with trauma exposure and PTSD among African American drug users","volume":"31","author":"Johnson","year":"2006","journal-title":"Addict. Behav."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/15504263.2021.2013096","article-title":"Associations Between Lifetime Panic Attacks, Posttraumatic Stress Disorder, and Substance Use Disorders in a Nationally Representative Sample","volume":"18","author":"Blakey","year":"2022","journal-title":"J. Dual Diagn."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jsat.2014.03.006","article-title":"Coping among military veterans with PTSD in substance use disorder treatment","volume":"47","author":"Kimerling","year":"2014","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.cpr.2005.05.006","article-title":"Is traumatic stress a vulnerability factor for women with substance use disorders?","volume":"25","author":"Hien","year":"2005","journal-title":"Clin. Psychol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Etami, Y., Lildharrie, C., Manza, P., Wang, G.J., and Volkow, N.D. (2023). Neuroimaging in Adolescents: Post-Traumatic Stress Disorder and Risk for Substance Use Disorders. Genes, 14.","DOI":"10.20944\/preprints202310.0225.v1"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.18103\/mra.v12i8.5688","article-title":"Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review","volume":"12","author":"Hinckley","year":"2024","journal-title":"Med. Res. Arch."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/j.1530-0277.2007.00591.x","article-title":"Trauma and PTSD in patients with alcohol, drug, or dual dependence: A multi-center study","volume":"32","author":"Driessen","year":"2008","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/02791072.2008.10400665","article-title":"Women and addiction: A trauma-informed approach","volume":"40","author":"Covington","year":"2008","journal-title":"J. Psychoact. Drugs"},{"key":"ref_15","first-page":"283","article-title":"Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment","volume":"19","author":"McCauley","year":"2012","journal-title":"Clin. Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jsat.2018.04.001","article-title":"The long-term impact of post traumatic stress disorder on recovery from heroin dependence","volume":"89","author":"Mills","year":"2018","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jsat.2011.02.012","article-title":"Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence","volume":"41","author":"Drapkin","year":"2011","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1016\/j.addbeh.2004.02.061","article-title":"Substance use and posttraumatic stress disorders: Symptom interplay and effects on outcome","volume":"29","author":"Read","year":"2004","journal-title":"Addict. Behav."},{"key":"ref_19","first-page":"121","article-title":"Functional and Psychiatric Correlates of Comorbid Post-Traumatic Stress Disorder and Alcohol Use Disorder","volume":"39","author":"Straus","year":"2018","journal-title":"Alcohol. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0306-4603(98)00064-1","article-title":"Course and treatment of patients with both substance use and posttraumatic stress disorders","volume":"23","author":"Ouimette","year":"1998","journal-title":"Addict. Behav."},{"key":"ref_21","first-page":"e1647","article-title":"Comorbid Post-Traumatic Stress Disorder and Opioid Dependence","volume":"9","author":"Patel","year":"2017","journal-title":"Cureus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/10550887.2013.795467","article-title":"Comorbid posttraumatic stress disorder and opiate addiction: A literature review","volume":"32","author":"Fareed","year":"2013","journal-title":"J. Addict. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Maria-Rios, C.E., and Morrow, J.D. (2020). Mechanisms of Shared Vulnerability to Post-traumatic Stress Disorder and Substance Use Disorders. Front. Behav. Neurosci., 14.","DOI":"10.3389\/fnbeh.2020.00006"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"222","DOI":"10.5498\/wjp.v11.i6.222","article-title":"Brain reward circuitry: The overlapping neurobiology of trauma and substance use disorders","volume":"11","author":"Michaels","year":"2021","journal-title":"World J. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1101\/lm.044164.116","article-title":"Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction","volume":"24","author":"Pizzimenti","year":"2017","journal-title":"Learn. Mem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/jclp.21980","article-title":"Helping vulnerable populations: A comprehensive review of the treatment outcome literature on substance use disorder and PTSD","volume":"69","author":"Najavits","year":"2013","journal-title":"J. Clin. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.drugalcdep.2008.10.018","article-title":"Posttraumatic stress disorder and other psychopathology in substance abusing patients","volume":"101","author":"Cacciola","year":"2009","journal-title":"Drug Alcohol. Depend."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/10550887.2016.1168212","article-title":"Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models","volume":"35","author":"Danovitch","year":"2016","journal-title":"J. Addict. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3109\/10673229709030550","article-title":"The self-medication hypothesis of substance use disorders: A reconsideration and recent applications","volume":"4","author":"Khantzian","year":"1997","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.pnpbp.2013.10.011","article-title":"Dysregulated responses to emotions among abstinent heroin users: Correlation with childhood neglect and addiction severity","volume":"48","author":"Gerra","year":"2014","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_31","unstructured":"Sher, L., and Vilens, A. (2010). Neurobiology of Post-Traumatic Stress Disorder, Nova Biomedical."},{"key":"ref_32","first-page":"595","article-title":"Stress, trauma, and post-traumatic stress disorder","volume":"51","author":"Vermetten","year":"2009","journal-title":"Tijdschr. Psychiatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ynstr.2018.09.002","article-title":"Stress reactivity and the developmental psychopathology of adolescent substance use","volume":"9","author":"Chaplin","year":"2018","journal-title":"Neurobiol. Stress."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/0306-4603(95)00024-7","article-title":"Understanding comorbidity between PTSD and substance use disorders: Two preliminary investigations","volume":"20","author":"Saladin","year":"1995","journal-title":"Addict. Behav."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1369-1600.2008.00131.x","article-title":"Stress, alcohol and drug interaction: An update of human research","volume":"14","author":"Uhart","year":"2009","journal-title":"Addict. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/da.20751","article-title":"Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population","volume":"27","author":"Khoury","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Hinckley, J.D., and Danielson, C.K. (2022). Elucidating the Neurobiologic Etiology of Comorbid PTSD and Substance Use Disorders. Brain Sci., 12.","DOI":"10.3390\/brainsci12091166"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Leconte, C., Mongeau, R., and Noble, F. (2022). Traumatic Stress-Induced Vulnerability to Addiction: Critical Role of the Dynorphin\/Kappa Opioid Receptor System. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.856672"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.psychres.2013.11.001","article-title":"Association between gene variants and response to buprenorphine maintenance treatment","volume":"215","author":"Gerra","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1176\/ps.2008.59.9.1018","article-title":"Correlates of adverse childhood experiences among adults with severe mood disorders","volume":"59","author":"Lu","year":"2008","journal-title":"Psychiatr. Serv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.bbr.2013.02.026","article-title":"Not all stress is equal: CREB is not necessary for restraint stress reinstatement of cocaine-conditioned reward","volume":"246","author":"Briand","year":"2013","journal-title":"Behav. Brain Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.neuropharm.2017.01.037","article-title":"Alcohol, stress, and glucocorticoids: From risk to dependence and relapse in alcohol use disorders","volume":"122","author":"Blaine","year":"2017","journal-title":"Neuropharmacology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.neuron.2008.06.012","article-title":"A role for brain stress systems in addiction","volume":"59","author":"Koob","year":"2008","journal-title":"Neuron"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Wemm, S.E., and Sinha, R. (2019). Drug-induced stress responses and addiction risk and relapse. Neurobiol. Stress., 10.","DOI":"10.1016\/j.ynstr.2019.100148"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Kaplan, G.B., and Thompson, B.L. (2023). Neuroplasticity of the extended amygdala in opioid withdrawal and prolonged opioid abstinence. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1253736"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.physbeh.2016.02.024","article-title":"Substance use modulates stress reactivity: Behavioral and physiological outcomes","volume":"166","author":"Fosnocht","year":"2016","journal-title":"Physiol. Behav."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.biopsycho.2010.08.005","article-title":"Use of hair cortisol analysis to detect hypercortisolism during active drinking phases in alcohol-dependent individuals","volume":"85","author":"Stalder","year":"2010","journal-title":"Biol. Psychol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.euroneuro.2013.11.006","article-title":"Increased cortisol levels in hair of recent Ecstasy\/MDMA users","volume":"24","author":"Parrott","year":"2014","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s12031-015-0655-x","article-title":"Metabonomic Study of Biochemical Changes in Human Hair of Heroin Abusers by Liquid Chromatography Coupled with Ion Trap-Time of Flight Mass Spectrometry","volume":"58","author":"Xie","year":"2016","journal-title":"J. Mol. Neurosci."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Duan, C., Wu, Y., Yang, J., Chen, S., Pu, Y., and Deng, H. (2021). Simultaneous Determination of Cortisol, Cortisone, and Multiple Illicit Drugs in Hair among Female Drug Addicts with LC-MS\/MS. Molecules, 26.","DOI":"10.3390\/molecules26020516"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1176\/ajp.149.5.664","article-title":"Posttraumatic stress disorder among substance users from the general population","volume":"149","author":"Cottler","year":"1992","journal-title":"Am. J. Psychiatry"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/josh.12042","article-title":"Ten-year trends in physical dating violence victimization among U.S. adolescent females","volume":"83","author":"Howard","year":"2013","journal-title":"J. Sch. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1002\/jts.20381","article-title":"The relationship of sexual abuse, early initiation of substance use, and adolescent trauma to PTSD","volume":"22","author":"Kingston","year":"2009","journal-title":"J. Trauma. Stress."},{"key":"ref_54","first-page":"375","article-title":"Neurobiology of addictive behaviors and its relationship to methadone maintenance","volume":"67","author":"Stimmel","year":"2000","journal-title":"Mt. Sinai J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1159\/000026677","article-title":"Neuroendocrine responses to psychological stress in adolescents with anxiety disorder","volume":"42","author":"Gerra","year":"2000","journal-title":"Neuropsychobiology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1176\/appi.ajp.2007.05030503","article-title":"Stress, dysregulation of drug reward pathways, and the transition to drug dependence","volume":"164","author":"Koob","year":"2007","journal-title":"Am. J. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1521-0391.1998.tb00327.x","article-title":"Posttraumatic stress disorder and cocaine dependence. Order of onset","volume":"7","author":"Brady","year":"1998","journal-title":"Am. J. Addict."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jsat.2008.05.008","article-title":"Can emotion-focused coping help explain the link between posttraumatic stress disorder severity and triggers for substance use in young adults?","volume":"36","author":"Staiger","year":"2009","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.yfrne.2014.01.001","article-title":"Corticotropin releasing factor: A key role in the neurobiology of addiction","volume":"35","author":"Zorrilla","year":"2014","journal-title":"Front. Neuroendocr."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1037\/a0022212","article-title":"Stress, habits, and drug addiction: A psychoneuroendocrinological perspective","volume":"19","author":"Schwabe","year":"2011","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2492","DOI":"10.1038\/s41380-022-01501-1","article-title":"Corticosteroid sensitization drives opioid addiction","volume":"27","author":"Carmack","year":"2022","journal-title":"Mol. Psychiatry"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.neuropharm.2013.05.024","article-title":"Addiction as a stress surfeit disorder","volume":"76 Pt B","author":"Koob","year":"2014","journal-title":"Neuropharmacology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/10253890.2020.1823367","article-title":"Blunted opioid regulation of the HPA stress response during nicotine withdrawal: Therapeutic implications","volume":"24","author":"Nakajima","year":"2021","journal-title":"Stress"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00406-011-0223-5","article-title":"Psychobiological responses to unpleasant emotions in cannabis users","volume":"262","author":"Somaini","year":"2012","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.biopsych.2013.10.019","article-title":"Acute effects of heroin on negative emotional processing: Relation of amygdala activity and stress-related responses","volume":"76","author":"Schmidt","year":"2014","journal-title":"Biol. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s40618-014-0091-8","article-title":"Effects of cocaine on the hypothalamic\u2013pituitary\u2013adrenal axis","volume":"37","author":"Manetti","year":"2014","journal-title":"J. Endocrinol. Invest."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/FBP.0000000000000262","article-title":"Oxytocin, cortisol and 3,4-methylenedioxymethamphetamine: Neurohormonal aspects of recreational \u2018ecstasy\u2019","volume":"27","author":"Parrott","year":"2016","journal-title":"Behav. Pharmacol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1111\/adb.12665","article-title":"Craving, cortisol and behavioral alcohol motivation responses to stress and alcohol cue contexts and discrete cues in binge and non-binge drinkers","volume":"24","author":"Blaine","year":"2019","journal-title":"Addict. Biol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1038\/263242a0","article-title":"Selective activation of mesocortical DA system by stress","volume":"263","author":"Thierry","year":"1976","journal-title":"Nature"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"5274","DOI":"10.1073\/pnas.85.14.5274","article-title":"Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats","volume":"85","author":"Imperato","year":"1988","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/0006-3223(89)90271-0","article-title":"Similar effects of daily cocaine and stress on mesocorticolimbic dopamine neurotransmission in the rat","volume":"25","author":"Kalivas","year":"1989","journal-title":"Biol. Psychiatry"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/s11920-007-0050-6","article-title":"The role of stress in addiction relapse","volume":"9","author":"Sinha","year":"2007","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"16149","DOI":"10.1523\/JNEUROSCI.2827-10.2010","article-title":"Ventral tegmental afferents in stress-induced reinstatement: The role of cAMP response element-binding protein","volume":"30","author":"Briand","year":"2010","journal-title":"J. Neurosci."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"20706","DOI":"10.3402\/ejpt.v4i0.20706","article-title":"Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis","volume":"4","author":"Cloitre","year":"2013","journal-title":"Eur. J. Psychotraumatol"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Heerde, J.A., Merrin, G.J., Le, V.T., Toumbourou, J.A.-O., and Bailey, J.A.-O. (2023). Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study. Int. J. Env. Res. Public. Health, 20.","DOI":"10.3390\/ijerph20031711"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0140-6736(17)32812-X","article-title":"Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): A multicentre, open-label, randomised controlled trial","volume":"391","author":"Lee","year":"2018","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1037\/dev0000511","article-title":"Discrimination, segregation, and chronic inflammation: Testing the weathering explanation for the poor health of Black Americans","volume":"54","author":"Simons","year":"2018","journal-title":"Dev. Psychol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Webb, E.K., Carter, S.E., Ressler, K.J., Fani, N., and Harnett, N.G. (2024). The neurophysiological consequences of racism-related stressors in Black Americans. Neurosci. Biobehav. Rev., 161.","DOI":"10.1016\/j.neubiorev.2024.105638"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Vlachos, I.I., Papageorgiou, C., and Margariti, M. (2020). Neurobiological Trajectories Involving Social Isolation in PTSD: A Systematic Review. Brain Sci., 10.","DOI":"10.3390\/brainsci10030173"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1002\/jcop.21963","article-title":"Community violence and posttraumatic stress disorder symptoms in urban youth: The moderating influence of friend and parent support","volume":"46","author":"Affrunti","year":"2018","journal-title":"J. Community Psychol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.neuroscience.2021.06.010","article-title":"Community Violence Exposure is Associated with Hippocampus-Insula Resting State Functional Connectivity in Urban Youth","volume":"468","author":"Reda","year":"2021","journal-title":"Neuroscience"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0954579409990228","article-title":"Neurobiological adaptations to violence across development","volume":"22","author":"Mead","year":"2010","journal-title":"Dev. Psychopathol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.physbeh.2004.02.008","article-title":"Opioids and alcoholism","volume":"81","author":"Oswald","year":"2004","journal-title":"Physiol. Behav."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1096\/fasebj.12.2.199","article-title":"Inherent glucocorticoid response potential of isolated hypothalamic neuroendocrine neurons","volume":"12","author":"Hellbach","year":"1998","journal-title":"FASEB J."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0301-0082(98)00039-2","article-title":"Release of neurotransmitters in the locus coeruleus","volume":"56","author":"Singewald","year":"1998","journal-title":"Prog. Neurobiol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s002130000673","article-title":"Opposing regulation of the locus coeruleus by corticotropin-releasing factor and opioids. Potential for reciprocal interactions between stress and opioid sensitivity","volume":"158","author":"Valentino","year":"2001","journal-title":"Psychopharmacology"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/S0893-133X(01)00416-X","article-title":"Hypothalamic-pituitary-adrenocortical (HPA) axis response and biotransformation of oral naltrexone: Preliminary examination of relationship to family history of alcoholism","volume":"26","author":"King","year":"2002","journal-title":"Neuropsychopharmacology"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1056\/NEJM197905033001817","article-title":"Naloxone increases ACTH and cortisol levels in man","volume":"300","author":"Volavka","year":"1979","journal-title":"N. Engl. J. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1097\/01.ALC.0000172459.71517.05","article-title":"Hormone responses to social stress in abstinent alcohol-dependent subjects and social drinkers with no history of alcohol dependence","volume":"29","author":"Munro","year":"2005","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_90","first-page":"2138","article-title":"Relationship between plasma adrenocorticotropin, hypothalamic opioid tone, and plasma leptin","volume":"83","author":"Wand","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0079-6123(07)67011-3","article-title":"The functional neuroanatomy of PTSD: A critical review","volume":"167","author":"Liberzon","year":"2008","journal-title":"Prog. Brain Res."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1126\/science.7268445","article-title":"Long-term stress-induced analgesia and activation of the opiate system","volume":"213","author":"Grau","year":"1981","journal-title":"Science"},{"key":"ref_93","first-page":"13","article-title":"Neurobiology of posttraumatic stress disorder","volume":"14","author":"Heim","year":"2009","journal-title":"CNS Spectr."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/da.20292","article-title":"Noradrenergic dysfunction and the psychopharmacology of posttraumatic stress disorder","volume":"25","author":"Strawn","year":"2008","journal-title":"Depress. Anxiety"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1159\/000334411","article-title":"The impact of diacetylmorphine on hypothalamic-pituitary-adrenal axis activity and heroin craving in heroin dependence","volume":"18","author":"Gerber","year":"2012","journal-title":"Eur. Addict. Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1080\/00952990802385781","article-title":"Let al. Dysfunction of the hypothalamic-pituitary-adrenal axis in opioid dependent subjects: Effects of acute and protracted abstinence","volume":"34","author":"Zhang","year":"2008","journal-title":"Am. J. Drug Alcohol. Abus."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1056\/NEJMoa0903326","article-title":"Morphine Use after Combat Injury in Iraq and Post-Traumatic Stress Disorder","volume":"362","author":"Holbrook","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1097\/00004583-200108000-00013","article-title":"Relationship Between Acute Morphine and the Course of PTSD in Children With Burns","volume":"40","author":"Saxe","year":"2001","journal-title":"J. Am. Acad. Child. Adolesc. Psychiatry"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1038\/s41386-019-0559-5","article-title":"Chronic opioid pretreatment potentiates the sensitization of fear learning by trauma","volume":"45","author":"Pennington","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.neuron.2004.08.005","article-title":"Neuropeptide S: A neuropeptide promoting arousal and anxiolytic-like effects","volume":"43","author":"Xu","year":"2004","journal-title":"Neuron"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00213-013-3195-5","article-title":"Role of kappa-opioid receptors in stress and anxiety-related behavior","volume":"229","author":"Carlezon","year":"2013","journal-title":"Psychopharmacology"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1300\/J069v25n02_02","article-title":"Relationship between plasma cortisol levels, withdrawal symptoms and craving in abstinent and treated heroin addicts","volume":"25","author":"Nava","year":"2006","journal-title":"J. Addict. Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000346110","article-title":"Atrial natriuretic peptide, arginine vasopressin peptide and cortisol serum levels in opiate-dependent patients","volume":"67","author":"Glahn","year":"2013","journal-title":"Neuropsychobiology"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/1355621031000069846","article-title":"Neuroendocrine correlates of antisocial personality disorder in abstinent heroin-dependent subjects","volume":"8","author":"Gerra","year":"2003","journal-title":"Addict. Biol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/j.arthro.2009.05.013","article-title":"Three-dimensional in vivo patellofemoral kinematics and contact area of anterior cruciate ligament-deficient and -reconstructed subjects using magnetic resonance imaging","volume":"25","author":"Shin","year":"2009","journal-title":"Arthroscopy"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0740-5472(87)80014-4","article-title":"The relationship of addiction, tolerance, and dependence to alcohol and drugs: A neurochemical approach","volume":"4","author":"Miller","year":"1987","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_107","first-page":"53","article-title":"Tolerance and dependence: Implications for the pharmacological treatment of addiction","volume":"76","author":"Kreek","year":"1987","journal-title":"NIDA Res. Monogr."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1001\/archpsyc.1994.03950090045007","article-title":"Noradrenergic dysregulation during discontinuation of cocaine use in addicts","volume":"51","author":"McDougle","year":"1994","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1159\/000123927","article-title":"Differences in hypothalamo-pituitary-adrenocortical activity in the rat after acute and prolonged treatment with morphine","volume":"38","author":"Buckingham","year":"1984","journal-title":"Neuroendocrinology"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1159\/000124820","article-title":"Interrelationships of opioidergic and adrenergic mechanisms controlling the secretion of corticotrophin releasing factor in the rat","volume":"46","author":"Buckingham","year":"1987","journal-title":"Neuroendocrinology"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0306-4522(02)00105-7","article-title":"Role of corticotropin-releasing hormone in the amygdala and bed nucleus of the stria terminalis in the behavioral, pain modulatory, and endocrine consequences of opiate withdrawal","volume":"112","author":"McNally","year":"2002","journal-title":"Neuroscience"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.neuroscience.2009.06.029","article-title":"Subcellular plasticity of the corticotropin-releasing factor receptor in dendrites of the mouse bed nucleus of the stria terminalis following chronic opiate exposure","volume":"163","author":"Jaferi","year":"2009","journal-title":"Neuroscience"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1017\/S1461145713000588","article-title":"Brain stress system response after morphine-conditioned place preference","volume":"16","author":"Milanes","year":"2013","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1523\/JNEUROSCI.17-07-02605.1997","article-title":"Corticotropin-releasing factor, but not corticosterone, is involved in stress-induced relapse to heroin-seeking in rats","volume":"17","author":"Shaham","year":"1997","journal-title":"J. Neurosci."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00008877-199501000-00011","article-title":"Suppression of corticotropin-releasing factor in the amygdala attenuates aversive consequences of morphine withdrawal","volume":"6","author":"Heinrichs","year":"1995","journal-title":"Behav. Pharmacol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1369-1600.2010.00205.x","article-title":"Heroin reduces startle and cortisol response in opioid-maintained heroin-dependent patients","volume":"16","author":"Walter","year":"2011","journal-title":"Addict. Biol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"R183","DOI":"10.1530\/EJE-18-0270","article-title":"Mechanisms of Endocrinology: Endocrinology of opioids","volume":"179","author":"Fountas","year":"2018","journal-title":"Eur. J. Endocrinol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1002\/jts.22474","article-title":"Commentary on the Special Section on Complex PTSD: Still Going Strong After All These Years","volume":"32","author":"Ford","year":"2019","journal-title":"J. Trauma. Stress."},{"key":"ref_119","first-page":"17","article-title":"Life events (loss and traumatic) and emotional responses to them in heroin-dependent patients before and after the dependence age of onset","volume":"13","author":"Rugani","year":"2011","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0306-4530(00)00046-9","article-title":"Neuroendocrine responses to experimentally-induced psychological stress in healthy humans","volume":"26","author":"Gerra","year":"2001","journal-title":"Psychoneuroendocrinology"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.biopsych.2009.02.015","article-title":"Enhanced choice for viewing cocaine pictures in cocaine addiction","volume":"66","author":"Moeller","year":"2009","journal-title":"Biol. Psychiatry"},{"key":"ref_122","first-page":"1244","article-title":"Towards a unitary perspective between Post-Traumatic Stress Disorder and Substance Use Disorder","volume":"55","author":"Rugani","year":"2014","journal-title":"Heroin Use Disord. Case study. Compr. Psychiatry"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1037\/0021-843X.115.2.369","article-title":"PTSD and substance-related problems: The mediating roles of disconstraint and negative emotionality","volume":"115","author":"Miller","year":"2006","journal-title":"J. Abnorm. Psychol."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"First, M.B., Spitzer, R.L., Gibbon, M., Gibbon, W., and Janet, B.W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV), American Psychiatric Press.","DOI":"10.1037\/t07827-000"},{"key":"ref_125","first-page":"49","article-title":"Life events (loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events","volume":"17","author":"Massimetti","year":"2015","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1080\/1042819031000123573","article-title":"Post-traumatic stress disorder and quality of life in long-term survivors of Hodgkin\u2019s disease and non-Hodgkin\u2019s lymphoma in Israel","volume":"44","author":"Geffen","year":"2003","journal-title":"Leuk. Lymphoma"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jpsychores.2010.09.017","article-title":"A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer","volume":"70","author":"Goncalves","year":"2011","journal-title":"J. Psychosom. Res."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1007\/s10880-012-9323-2","article-title":"Prevalence and significant determinants of post-traumatic stress disorder in a large sample of patients with multiple sclerosis","volume":"20","author":"Ostacoli","year":"2013","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"4526","DOI":"10.1200\/JCO.2011.37.2631","article-title":"Post-traumatic stress symptoms in long-term non-Hodgkin\u2019s lymphoma survivors: Does time heal?","volume":"29","author":"Smith","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1200\/JCO.2007.12.3414","article-title":"Post-traumatic stress outcomes in non-Hodgkin\u2019s lymphoma survivors","volume":"26","author":"Smith","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/pon.2109","article-title":"Posttraumatic stress disorder (PTSD) in survivors of Hodgkin\u2019s lymphoma: Prevalence of PTSD and partial PTSD compared with sibling controls","volume":"22","author":"Varela","year":"2013","journal-title":"Psycho Oncol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1080\/13548506.2011.579991","article-title":"HIV infection associated post-traumatic stress disorder and post-traumatic growth\u2014A systematic review","volume":"16","author":"Sherr","year":"2011","journal-title":"Psychol. Health Med."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s40263-013-0051-4","article-title":"Recent progress in understanding the pathophysiology of post-traumatic stress disorder: Implications for targeted pharmacological treatment","volume":"27","author":"Bailey","year":"2013","journal-title":"CNS Drugs"},{"key":"ref_134","first-page":"379","article-title":"Biological basis of posttraumatic stress disorder","volume":"28","author":"Molina","year":"2000","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s001150050511","article-title":"Psychobiological aspects of posttraumatic stress disorder","volume":"70","author":"Ehlert","year":"1999","journal-title":"Nervenarzt"},{"key":"ref_136","first-page":"21","article-title":"Biological basis of posttraumatic stress disorder","volume":"25","author":"Graef","year":"2003","journal-title":"Braz. J. Psychiatry"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3109\/00048678909062145","article-title":"Low plasma beta-endorphin in post-traumatic stress disorder","volume":"23","author":"Hoffman","year":"1989","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_138","first-page":"4","article-title":"Neuronal mechanisms underlying main clinical syndromes of post-traumatic stress disorder","volume":"87","author":"Khozhenko","year":"2009","journal-title":"Klin Med."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.brainres.2009.09.074","article-title":"Dynorphin, stress, and depression","volume":"1314","author":"Knoll","year":"2010","journal-title":"Brain Res."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.npep.2010.12.004","article-title":"Extending pharmacological spectrum of opioids beyond analgesia: Multifunctional aspects in different pathophysiological states","volume":"45","author":"Sauriyal","year":"2011","journal-title":"Neuropeptides"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.brainres.2009.08.062","article-title":"The dynorphin\/kappa opioid system as a modulator of stress-induced and pro-addictive behaviors","volume":"1314","author":"Bruchas","year":"2010","journal-title":"Brain Res."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1021\/jm301783x","article-title":"Development of \u03ba Opioid Receptor Antagonists","volume":"56","author":"Carroll","year":"2013","journal-title":"J. Med. Chem."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0143-4179(84)90081-7","article-title":"ACTH, cortisol and beta-endorphin response to metyrapone testing during chronic methadone maintenance treatment in humans","volume":"5","author":"Kreek","year":"1984","journal-title":"Neuropeptides"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/S0893-133X(00)00222-0","article-title":"Altered HPA axis responsivity to metyrapone testing in methadone maintained former heroin addicts with ongoing cocaine addiction","volume":"24","author":"Schluger","year":"2001","journal-title":"Neuropsychopharmacology"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.biopsych.2008.10.032","article-title":"A study of the protective function of acute morphine administration on subsequent posttraumatic stress disorder","volume":"65","author":"Bryant","year":"2009","journal-title":"Biol. Psychiatry"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1097\/BCR.0b013e3181b48102","article-title":"Preliminary evidence for the effects of morphine on posttraumatic stress disorder symptoms in one- to four-year-olds with burns","volume":"30","author":"Stoddard","year":"2009","journal-title":"J. Burn. Care Res."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1744-859X-9-15","article-title":"Subtyping Patients with Heroin Addiction at Treatment Entry: Factors Derived fron the SCL-90","volume":"9","author":"Maremmani","year":"2010","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.comppsych.2017.10.001","article-title":"Towards a psychopathology specific to Substance Use Disorder: Should emotional responses to life events be included?","volume":"80","author":"Maremmani","year":"2018","journal-title":"Compr. Psychiatry"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12991-014-0035-x","article-title":"Psychopathological symptoms of heroin-addicted patients entering opioid agonist or therapeutic community treatment","volume":"13","author":"Pani","year":"2014","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_150","first-page":"17","article-title":"Psychopathological symptoms in detoxified and non-detoxified heroin-dependent patients entering residential treatment","volume":"17","author":"Pani","year":"2015","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_151","first-page":"29","article-title":"The SCL90-based psychopathological structure may be applied in Substance Use Disorder patients irrespectively of the involved drug also in heroin, alcohol and cocaine mono-drug users","volume":"20","author":"Carbone","year":"2018","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1038\/nn1583","article-title":"Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction","volume":"8","author":"Kreek","year":"2005","journal-title":"Nat. Neurosci."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/0024-3205(83)90529-5","article-title":"Circadian rhythms and levels of beta-endorphin, ACTH, and cortisol during chronic methadone maintenance treatment in humans","volume":"33","author":"Kreek","year":"1983","journal-title":"Life Sci."},{"key":"ref_154","first-page":"5","article-title":"Craving in Opiate, Cocaine and Alcohol Addiction","volume":"6","author":"Kreek","year":"2004","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_155","first-page":"37","article-title":"Prominent psychopathological and clinical characteristics of Heroin Post-Traumatic Stress Disorder Spectrum patients during treatment","volume":"22","author":"Maremmani","year":"2020","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_156","unstructured":"Maremmani, I., and Castrogiovanni, P. (1989). DAH-Q: Drug Addiction History Questionnaire, University Press."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/bs.3830190102","article-title":"The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory","volume":"19","author":"Derogatis","year":"1974","journal-title":"Behav. Sci."},{"key":"ref_158","first-page":"51","article-title":"An inventory for assessing the behavioural covariates of craving in heroin substance use disorder. Development, theoretical description, reliability, exploratory factor analysis and preliminary construct validity","volume":"17","author":"Maremmani","year":"2015","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.comppsych.2008.11.006","article-title":"A multidimensional spectrum approach to post-traumatic stress disorder: Comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR)","volume":"50","author":"Carmassi","year":"2009","journal-title":"Compr. Psychiatry"},{"key":"ref_160","first-page":"26158","article-title":"Which Posttraumatic Stress Disorder Symptoms, Trauma Types, and Substances Correlate With Suicide Attempts in Trauma Survivors?","volume":"19","author":"Guina","year":"2017","journal-title":"Prim. Care Companion CNS Disord."},{"key":"ref_161","first-page":"41","article-title":"Nearly thirty years of experience of real-world long-term treatment with Opioid Agonists","volume":"22","author":"Lamanna","year":"2020","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_162","first-page":"1","article-title":"Negative dimension in psychiatry. Amotivational syndrome as a paradigm of negative symptoms in substance abuse","volume":"48","author":"Rovai","year":"2013","journal-title":"Riv. Psichiatr."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jad.2013.06.054","article-title":"The long-term outcomes of heroin dependent-treatment-resistant patients with bipolar 1 comorbidity after admission to enhanced methadone maintenance","volume":"151","author":"Maremmani","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1159\/000321465","article-title":"Effect of psychiatric severity on the outcome of methadone maintenance treatment","volume":"17","author":"Pani","year":"2011","journal-title":"Eur. Addict. Res."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1745-0179-4-2","article-title":"Validity and reliability of the Structured Clinical Interview for the Trauma and Loss Spectrum (SCI-TALS)","volume":"4","author":"Shear","year":"2008","journal-title":"Clin. Pr. Epidemiol. Ment. Health"},{"key":"ref_166","first-page":"29","article-title":"The TALS\u2014Reduced form: An inventory for assessing the Heroin Post-Traumatic Stress Disorder Spectrum (H\/PTSD-S)","volume":"22","author":"Maremmani","year":"2020","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"17","DOI":"10.62401\/2531-4122-2025-17","article-title":"Assessing Subjective Wellness in Heroin Use Disorder. Part III: Convergent and Discriminant Validity of the DM-SWS. Correlations with demographics, Symptom Scales and Behavioural Questionnaires","volume":"27","author":"Maremmani","year":"2025","journal-title":"Heroin Addict. Relat. Clin. 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