Although ample evidence has documented sex differences in the course of drug addiction, neuroendocrine contributions to these sex differences have not been fully explored. Oral contraceptive pills are used by the majority of women in the US for at least one period of their reproductive years, and dramatically decrease sex hormone levels. However, any potential relationship between oral contraceptives and drug abuse/dependence that may relate to or explain previously observed sex differences has never been formally investigated to our knowledge. We hypothesize that the change in hormones caused by oral contraceptive use can decrease performance on an emotion regulation task that activates regions of the brain previously shown be less active in oral contraceptive users. Deficits in emotion regulation have been linked to substance abuse problems. Therefore, we propose to investigate whether oral contraceptives decrease emotion regulation as a first step toward determining whether they can influence efforts toward drug abstinence.
This proposal is a response to PA-14-036, Women & Sex/Gender Differences in Drug and Alcohol Abuse/Dependence, addressing the goal of identifying how ovarian hormone status influences the biological substrates of drug abuse. Specifically, we hypothesize that the use of oral contraceptive pills, which alter hormone levels, can alter brain function in a way that leads to deficits in emotion regulation. Previous literature has shown that people with substance use disorders have, on average, deficits in emotion regulation, and that improving emotion regulation decreases the frequency of substance use; therefore, a finding in this study that oral contraceptive pills decrease successful emotion regulation may lead to a change in the cost/benefit analysis for women attempting to become abstinent from drug use, which can be assessed with their treatment provider or team.
