Plasma levels of beta-endorphin, adrenocorticotropic hormone and cortisol during early and late alcohol withdrawal

Endogenous opioid peptides are thought to participate in the phenomena of a lcohol tolerance and withdrawal. Since in the pituitary gland, beta-endorph in (beta -EP) and adrenocorticotropic hormone (ACTH) are produced from the same precursor molecule, pro-opiomelanocortin, it may be expected that alte rations in plasma ACTH and cortisol levels should parallel changes in plasm a beta -EP levels during alcohol withdrawal. The aim of the present study w as to investigate the alterations of beta -EP, AC7H and cortisol secretion patterns in alcohol-dependent patients with heavy intake in the early withd rawal period and, if any, whether these changes remained stable on long-ter m withdrawal. Twenty-two hospitalized male patients (mean age +/- SD: 43.45 +/- 9.22 years, mean daily amount of alcohol +/- SD: 421.59 +/- 116.57 g) who were diagnosed to have alcohol withdrawal and 20 age-matched healthy me n (mean age +/- SD: 38.35 +/- 7.63 years) were included in the study. Morni ng and night levels of plasma beta -ER ACTH and cortisol were measured in t he patients during the early (first week) and late (fourth week) withdrawal periods following alcohol cessation, and only once in the control subjects . It was found that both morning beta -EP and morning ACTH levels were redu ced during both early and late withdrawals, whereas cortisol levels were in creased in early withdrawal and normalized towards the late withdrawal peri od. The finding that beta -EP deficiency continued despite withdrawal sympt oms subsiding in patients suggests that their beta -EP deficiency is indepe ndent of the withdrawal syndrome and that reduced beta -EP activity may be a trait contributing to alcohol craving.