Research reveals a connection between hormone imbalance and drug addiction. Specifically, estrogen dominant states seem to increase factors that could make drug addiction more likely and contribute to difficulty in recovery from addiction. Progesterone therapy, which can be used to correct estrogen dominance, may have utility in assisting recovery from drugs of abuse.[1]
Two research questions have been repeatedly studied in recent years. The first is ‘How do estrogen and progesterone levels affect responses to drugs of abuse?’ The second question is ‘Can progesterone supplementation assist in maintaining abstinence among recovering addicted individuals?’
Progesterone and Estrogen and Drug Response
To study the effect of hormone balance on drug response, trials have been completed involving cocaine, amphetamines, tobacco and marijuana. Participants were grouped by progesterone and estradiol levels, by phase of the menstrual cycle, and/or by gender. In other studies, subjects supplementing with progesterone were compared to those given placebo. Then, researchers administered the recreational drug being studied and monitored or surveyed participants’ responses.
In states of higher progesterone levels, such as luteal phase or after progesterone administration, researchers observed a trend towards attenuated responses to recreational drugs. For example, women in luteal phase reported feeling less ‘high’ after cocaine administration as compared to women in the follicular phase or to men.[2] Conversely, women in the follicular phase, when progesterone levels are lower and estradiol levels are higher, reported higher ratings of feeling ‘high’, ‘stimulated’, and experiencing a ‘good drug effect’ after using cocaine.[3] Supplementing progesterone has been shown to lower the rating of cocaine-induced highs in both men and women.[4]
Research involving marijuana, nicotine and amphetamines follows the same trend. Estrogen generally increases and progesterone generally decreases the rewarding effects of these substances.
Progesterone as Therapy for Recovery and Withdrawal
A number of recent studies have examined progesterone as a potential intervention in recovery from nicotine and cocaine dependence. Progesterone supplementation in postpartum mothers who quit smoking during pregnancy was associated with reduced nicotine craving and an average of 6 more weeks of abstinence from smoking.[5] In a double-blind, placebo-controlled study, a 400 mg oral daily dose of progesterone reduced tobacco smoking urges in both male and female abstinent smokers. Cognitive performance, often negatively affected during smoking cessation, improved with a 200 mg oral dose of progesterone.[6]
In a study of over 200 female smokers randomly assigned to quit during luteal or follicular phase, those in the luteal phase took longer to relapse.[7] This suggests that higher progesterone levels may assist in smoking cessation success. Similarly, when cocaine-dependent women in recovery were exposed to stress or to drug cues, those with higher progesterone levels responded with lower levels of cravings, lower blood pressure, and lower anxiety levels.[8]
The Future of Addiction Recovery Treatment
Research suggests progesterone may be an important component of a holistic approach to supporting addiction recovery. The current evidence suggests that progesterone supplementation may assist in smoking cessation in women of reproductive age. Research has yet to determine if progesterone can confer equal benefits to women during all phases of life, especially during times of hormonal transition. There are fewer studies looking at the utility of progesterone supplementation for men in recovery, but the research done so far shows promise. The case for progesterone as a recovery tool for cocaine, amphetamine and marijuana cessation continues to grow.
For providers who advise patients with nicotine or cocaine addiction, testing estradiol and progesterone levels may provide beneficial insight. Checking the progesterone to estradiol ratio will allow providers to administer progesterone as needed. If progesterone is supplemented the patient may benefit not only from the reduction of estrogen dominant symptoms and associated proliferative risks but could also be supported in the process of recovery. As a result, cycling women who set their quit date during the luteal phase might increase their chances of maintaining abstinence longer.
