Does a Preoccupation With Drug Cues Increase Risk for Cocaine Relapse?

Essentially all people with a substance addiction are affected by drug cues that increase their chances of engaging in substance use in certain circumstances. In the context of substance treatment, the presence of these cues can significantly increase the odds that any given person will relapse back into active substance intake. In a study published in September/October 2014 in The American Journal on Addictions, a group of American researchers sought to determine if a particular preoccupation with drug cues before entering treatment increases the likelihood of a relapse in people recovering from cocaine addiction.

Drug Cues and Drug Craving

A drug cue is any internal or environmental stimulus that increases the odds that a substance user will consume drugs or alcohol in the immediate or near future. Depending on the individual, a number of things can acts as such cues, including being in physical locations where substance use previously occurred, associating with other substance users, experiencing emotional or psychological states previously linked to substance intake and experiencing thought patterns that reinforce the substance-using reflex. Some affected individuals know which cues make them more likely to participate in substance use, while others do not. In addition, some affected individuals may develop an unusually high degree of preoccupation with their recognized or unrecognized drug cues.

Drug cravings are the common end result of exposure to drug cues. In a person affected by substance addiction, a craving can also appear without any reference to a drug cue if the brain’s baseline need for intake of the substance in question goes unmet. Whether or not it stems from a specific drug cue, a strong craving can significantly destabilize the successful establishment of abstinence in substance treatment.

Cues, Craving and Cocaine Addiction

Drug cues and drug craving are well-known factors in recovery from cocaine addiction. Like treatment programs targeted at many other forms of addiction, cocaine treatment programs consist largely of therapies that help the individual learn to recognize the presence of craving, learn how to identify the drug cues that contribute to the intensity of craving and learn how to avoid engaging in substance use when cue-driven drug cravings appear. These therapies are especially important in cocaine addiction treatment, since doctors have no reliable medication options to help their patients/clients deal with the drug’s damaging effects.

Impact on Cocaine Relapse Risks

Researchers and addiction specialists use the term “attentional bias” to refer to the tendency of people affected by addiction to become heavily preoccupied with various aspects of substance intake. In the study published in The American Journal on Addictions, researchers from Emory University, the University of Arkansas for Medical Sciences and the federal Veterans Administration used information gathered from a small project involving 35 adults to help determine if drug cue preoccupation or attentional bias at the beginning of substance treatment increases the odds that a person affected by cocaine addiction will relapse back into active drug use. All 35 of these adults were addicted to cocaine. Instead of exposing these individuals to generalized drug cues that might have an impact on the behavior of any cocaine user, the researchers created unique drug cues specifically targeted at the known preferences of each study participant. These cues included words and word combinations designed to increase the desire to use cocaine.

The researchers concluded that custom-designed drug cues were indeed able to create a preoccupation or attentional bias in the study participants. However, they also concluded that recovering cocaine addicts impacted by this preoccupation do not have a significantly higher chance of experiencing a relapse than recovering addicts not affected by an unusual preoccupation with drug cues at the beginning of treatment.

The study’s authors do not believe their findings definitively show that cocaine addicts highly preoccupied with drug cues don’t have an increased risk for relapse in substance treatment. However, they do believe that their findings fail to indicate the presence of increased relapse risks for these individuals. It’s worth noting that the study included a male-dominated group of participants. In line with this fact, the authors limit the scope of their conclusions to men affected by cocaine addiction and do not address the relapse-related impact of drug cue preoccupation in cocaine-addicted women.

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