Habitual cocaine uses have clear risks for the onset of stimulant use disorder, a diagnosis that covers both non-addicted cocaine abuse and cocaine addiction. Once addicted, cocaine users who enter treatment have considerable risks for relapsing back into active consumption, even if they successfully maintain drug abstinence for extended amounts of time. In a study published in September 2014 in the journal Neuron, a multinational research team examined a built-in brain response that apparently helps people affected by cocaine addiction diminish their relapse risks.
Cocaine is addictive because it seriously alters the chemical levels in a part of the brain known informally as the pleasure center. In the short term, this chemical alteration leads to, among other things, a powerful sensation called euphoria. With repeated exposure to cocaine, the chemical changes in the pleasure center can become lasting and lead the brain to perceive the presence of the drug as part of its essential operating conditions. Doctors and addiction specialists refer to this cocaine-reliant state as cocaine dependence. Practically speaking, cocaine dependence is synonymous with cocaine addiction, the highly dysfunctional state characterized by such things as a recurring urge to consume more of the stimulant, rising tolerance to the drug effects of any given amount of the stimulant, establishment of a cocaine-centric daily routine and the development of a withdrawal syndrome when cocaine consumption does not meet the brain’s established chemical needs. Additional problems found in cocaine addicts and heavy, non-addicted abusers include bouts of extreme anxiety, bouts of psychosis and damaging changes in heart and blood vessel function.
Generally speaking, a substance relapse occurs when an addicted individual who has established a pattern of abstinence breaks that pattern and returns to active use either temporarily or permanently. Common factors that contribute to the onset of a relapse in any addicted person include a desire to avoid the highly unpleasant symptoms of substance withdrawal and exposure to various drug cues, which are internal and external reminders of a previously developed, substance-centered routine.
All people affected by drug or alcohol addiction are at risk for a relapse at some point during the recovery process, the National Institute on Drug Abuse notes. In fact, to a certain extent, relapse incidents are to be expected as a fairly inevitable setback even for people who ultimately maintain an enduring pattern of abstinence. People affected by cocaine addiction may have an unusually high susceptibility to a relapse. This fact holds true, in part, because of the persistent strength of the drug cues that arise in the minds of recovering cocaine users or appear in recovering users’ surrounding environments.
Improved Relapse Understanding
In the study published in Neuron, researchers from the U.S., China and Germany used laboratory testing on rats to explore the ways in which the brain attempts to cope with the risks for a cocaine relapse. This testing built on prior efforts from the same research team, which showed that certain nerve cell connections inside the brain become active only when an addicted cocaine user stops taking the drug and goes through withdrawal. Essentially, these activated connections send signals that substantially increase the urge to use cocaine when an affected individual is exposed to drug use cues.
In the current study, the researchers examined the brain connections of cocaine-addicted rats that went through withdrawal and were denied access to the drug for 45 days. After completing this examination, they concluded that not all of the newly active brain connections produce conditions that increase the risks for a relapse. Instead, some of the new connections in the brain’s pleasure center actually make the individual less sensitive to drug cues and decrease that individual’s relapse odds. Just like the brain process that favors a relapse, this anti-relapse process apparently only switches on after exposure to cocaine has occurred.
The study’s authors note that, altogether, the relapse-supporting connections in the brains of recovering cocaine addicts substantially outnumber the relapse-preventing connections. However, they believe their findings demonstrate that the brain has at least some natural ability to fight off a relapse. They also believe that, in time, researchers may find a way to decrease the impact of the relapse-supporting connections and/or increase the impact of the relapse-preventing connections. Ultimately, improved understanding may eventually lead to new treatments that enhance the brain’s built-in anti-relapse faculties.