People’s Unique Drug Cues Are the Most Powerful

Any given person’s level of craving for addictive substances typically rises when he or she is exposed to drug cues that are unique to the individual, according to recent findings from a team of French and American researchers.

Researchers and addiction specialists are well aware that recurring consumption of addictive substances is supported by the presence of strong urges, called drug cravings, which increase in intensity when a person encounters certain signals or cues related to prior substance use. In a study published in March 2015 in the journal Addiction, researchers from five French institutions and one American institution sought to determine if substance users respond more intensely to generalized drug cues shared by most fellow consumers or to specific cues that are unique to each person.

Drug Cravings

In its essence, a craving is a response that all humans have toward activities that increase their pleasure levels. Once you know that an activity will bring you pleasure, you can develop cravings for future instances of that activity while you’re involved in other aspects of your daily life. The intense and harmful cravings associated with substance use occur because the vast majority of addictive, mind-altering substances boost pleasure levels inside the brain by an unusually high amount. If you repeatedly consume drugs or alcohol, you can come to anticipate the high degree of pleasure associated with this activity (even though that pleasure typically diminishes over time). In turn, cravings for drug or alcohol use can promote increased consumption levels and ultimately set the stage for the long-term changes in brain function that mark the arrival of physical dependence and/or addiction.

In a person already addicted to drugs or alcohol, recurring cravings commonly lead to future instances of uncontrolled, dysfunctional substance intake. For this reason, the American Psychiatric Association officially views the presence of such cravings as one of the 11 diagnosable symptoms of substance use disorder (and substance-specific offshoots of this disorder such as cannabis use disorder, opioid use disorder and alcohol use disorder). A person with substance use disorder has problems with dependence/addiction, non-addicted substance abuse or overlapping issues of addiction and abuse.

Drug Cues

Drug cues are internal or external reminders of previous episodes of substance use. As a rule, the presence of such cues increases the intensity of cravings in substance consumers, and thereby increases the likelihood that uncontrolled substance intake will occur (typically in the near future). Cues can come in the form of emotions or thought processes that the individual has come to associate with drug or alcohol intake. They can also come in the form of memories triggered by being in physical locations where past substance use occurred, or in the form of social encounters with substance users in general or specific people with whom substance intake has occurred in the past.

Which Types of Cues Increase Cravings?

Some cues for substance use are fairly generic (including being in a bar, smelling cigarette smoke or watching someone engage in a drug-using routine). However, a substance consumer can also develop a range of idiosyncratic cues that mean little or nothing to other drug or alcohol users. In the study published in Addiction, researchers from the University of Pennsylvania and French institutions including the University of Bordeaux and the Center for Addiction used a project involving 132 adults to help determine if relatively generic substance cues or cues specific to the individual have a greater effect on drug craving levels. During the project, each participant used smartphone technology to record his or her craving levels while exposed to a range of cues over the course of a typical daily routine.

The researchers concluded that both person-specific drug cues and more generic cues associated with substance use appear to increase craving levels in a substance consumer. However, upon closer analysis, they found that only those cues that are unique to the individual actually increase daily levels of substance craving. This increase in craving levels predictably leads to short-term spikes in substance intake. The researchers believe that person-specific drug cues may have a stronger effect on the individual because their impact lasts for longer amounts of time than the impact of more generic cues shared by many consumers of a given substance. They note the potential usefulness of smartphone technology in increasing the scope of knowledge about unique drug cues, as well as in increasing the usefulness of interventions designed to reduce the intensity of drug cravings.

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