Have Researchers Found a Way to Prevent Cocaine Relapse?
People addicted to cocaine have fairly high chances of relapsing back into active drug use while attempting to establish abstinence. Unfortunately, there is no medication that consistently helps prevent such a relapse. However, in a study published in October 2014 in the journal Molecular Psychiatry, a team of American researchers uncovered a potential method of stopping cocaine-related relapses from occurring. This method relies on the slight alteration of a part of the brain that normally supports relapse in people recovering from cocaine addiction.
Cocaine Addiction and Relapse
Among its many effects, cocaine accesses a part of the brain called the pleasure center and increases levels of a euphoria-producing chemical called dopamine. The amount of short-term euphoria triggered by the presence of cocaine significantly exceeds the amount of euphoria associated with such pleasurable, life-sustaining activities as having sex or eating food. In practical terms, this means that a certain percentage of people who use the drug will start to rely on cocaine as a source of repeatable pleasure. However, repeated cocaine exposure alters normal function in the pleasure center and ultimately sets the stage for physical cocaine dependence, a condition that’s essentially synonymous with cocaine addiction.
People dependent on cocaine have a strong motivation to keep consuming the drug. When an addicted user enters a treatment program, this motivation does not simply fade away. In fact, an increased urge to consume the drug can easily appear since the user no longer has ready access to his or her accustomed cocaine intake. A cocaine relapse is defined by a resumption of active drug use by a cocaine-experienced individual attempting to establish a pattern of abstinence or by an individual who has already established abstinence. Such relapses occur frequently, and recovery programs must help their clients/patients cope with relapse episodes and return to a sober lifestyle.
Current Treatment Options
Treatment programs have medication-based options for helping people addicted to a number of substances, including alcohol and opioid drugs and medications. However, no such option exists to reliably help people affected by cocaine addiction deal with cocaine withdrawal at the beginning of the treatment process or ongoing risks for relapse over the course of treatment. Instead, cocaine-centered programs achieve their goals with the help of psychotherapeutic approaches known as behavioral interventions, as well as long-term inpatient programs known as therapeutic communities and mutual self-help programs (including 12-step programs) geared toward cocaine users and other drug users.
A New Approach to Relapse Prevention?
In the study published in Molecular Psychiatry, researchers from Harvard University-affiliated Massachusetts General Hospital and the University of Pennsylvania Perelman School of Medicine used animal testing in a laboratory setting to explore a new approach to preventing the onset of a relapse in people recovering from cocaine addiction. Specifically, the researchers looked at the changes in relapse risk that occur when sites inside the brain’s pleasure center, known as AMPA receptors, are slightly genetically altered. Normally, these receptors help produce chemical signals that encourage a return to cocaine intake in addicted users.
During the study, the researchers gave one group of rats free access to a supply of cocaine for three weeks; following this three-week period, they denied the animals all access to the drug for a week. After comparing the pleasure centers of the cocaine-experienced animals to the pleasure centers of a second group of rats not exposed to the drug, the researchers concluded that the cocaine-exposed group experienced changes in their AMPA receptors that apparently increased the desire to return to active drug intake. The researchers exposed a third group of rats to cocaine and then genetically altered the animals’ AMPA receptors. When these animals were given renewed access to cocaine after undergoing the genetic alteration, they exhibited a substantially diminished desire to use the drug.
The study’s authors believe that they may have uncovered a new approach to developing treatments that help people recovering from cocaine addiction. Essentially, this approach involves “turning off” or “turning down” the chemical signals that normally increase the intensity of cocaine-using urges in addicted individuals who stop taking the drug. Further research will be needed before anyone knows for sure if it’s possible to develop treatments of this type that have real-world effectiveness.