ArticleDrug and alcohol dependence2019
Changes in cardiac vagal tone as measured by heart rate variability during naloxone-induced opioid withdrawal.
Article in Drug and alcohol dependence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Controlled breathing and heart rate variability biofeedback for substance use-related outcomes: A systematic review and meta-analysis.Addiction (Abingdon, England) · 2026Pooled it
- Sinus Tachycardia Following Administration of Naloxone in a Dog During Anesthetic Recovery.Animals : an open access journal from MDPI · 2026Article
- Maternal psychophysiology profiles: associations with prenatal opioid use, maternal emotion dysregulation, and newborn neurobehavior.Pediatric research · 2025Article
- Heart Rate Variability for Supplementing Withdrawal Assessment in Patients with Opioid Dependence: An Exploratory Study.Indian journal of psychological medicine · 2024Article
- Investigating Ultra-Short-Term Heart Rate Variability as an Indicator of Craving in Recently Treated Patients with Opioid Use DisorderAnnual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2024Article
- The cell-permeant antioxidant D-thiol ester D-cysteine ethyl ester overcomes physical dependence to morphine in male Sprague Dawley rats.Frontiers in pharmacology · 2024Article
- Opioid Impacts on Cardiovascular Health.Cureus · 2023Review
- Lipophilic analogues of D-cysteine prevent and reverse physical dependence to fentanyl in male rats.Frontiers in pharmacology · 2023Article
- L-cysteine ethyl ester prevents and reverses acquired physical dependence on morphine in male Sprague Dawley rats.Frontiers in pharmacology · 2023Article
- Exploring the use of Granger causality for the identification of chemical exposure based on physiological data.Frontiers in network physiology · 2023Article
- Exploring of cardiac autonomic activity with heart rate variability in long-term kratom (PeerJ · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHeart rate variability (HRV) is of interest to researchers due to its potential utility as a marker for both physiological and psychological stress. Sympatholytics are used to treat opioid withdrawal, but little information about the parasympathetic system's role in mediating withdrawal symptoms exists. The goal of the current study was to evaluate changes in HRV during opioid withdrawal to provide a better understanding of the autonomic effects of opioid withdrawal.
methodsTen male participants (mean age = 46.4 years) received intramuscular naloxone (mean dose =0.26 mg) to confirm opioid dependence. The presence and severity of withdrawal symptoms were assessed using subjective and objective measures (Wang et al., 1974). Electrocardiography (ECG) was measured continuously, and HRV was analyzed in 2-minute segments before naloxone injection (at baseline) and after participants were in moderate withdrawal (Wang Test score ≥10). Heart rate, blood pressure, pupil diameter, and respiratory rate were also examined.
resultsPupil diameter significantly increased after naloxone administration relative to baseline (t(9) = 5.562, p = 0.000). Both high frequency (HF) HRV (Z = -2.803, p = 0.005) and root mean square of successive differences (RMSSD) HRV (Z = -2.090, p = 0.037) were significantly lower during withdrawal relative to baseline. Increases in heart rate (Z = -2.090, p = 0.032) and systolic pressure (t(9) = 8.099, p = 0.0000) from baseline to withdrawal also were significant.
conclusionsThese preliminary data indicate that a large reduction in cardiac vagal tone occurs during naloxone-induced withdrawal. This finding underscores the need for further research into the role of the parasympathetic nervous system in opioid withdrawal.
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