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It's time to cancel cravings. Fiona Grishaw-Jones

Sobriety is hard. 40-60% of people dealing with addiction relapse and start taking drugs again (Drugs, Brain, and Behavior: The Science of Addiction, 2018). Relapse is a serious problem and can set back people trying to treat their addictions.

Getting sober is only half the battle. Staying sober is a daily struggle for every person dealing with substance abuse. The constant reminder of drug experiences can trigger vivid memories—and cause cravings. These cravings increase the likelihood of relapse. No magic cure for substance abuse nor any way to prevent relapse exists; however, maybe there is a way to help lessen the tight hold cravings have on many with addiction.

Even if someone really wants to have control over their cravings, their subconscious brain, the part of the brain that controls drive and impulses, may not agree. Drug addiction hijacks normal mechanisms associated with reward and drive. Where a person was and who they were with when taking the drug are both examples of drug related memories. These long-term memories are powerful. They can act as cues, increase cravings, and the likelihood of relapse. Self-reported cravings can act as an indicator of relapse likelihood.

If memories can be cues that lead to relapse, how could we affect the way we process memories to help those struggling with addiction?

Every time we recall memories, we reactivate and restore them. This process of forming long-term memories is called reconsolidation. Interrupting the storage of long term, drug-related memories is a possible path to reducing self-reported cravings.

Propranolol is a beta blocker commonly used to treat heart disease by decreasing the release of adrenaline. It might also be used as reconsolidation impairment that affects the emotions surrounding an event. (Don’t worry! Propranolol will not cause sustained memory impairments!) Propranolol was used in a recent study with people who abuse alcohol, cocaine, prescription pills, and marijuana (Lonergan et al. 2015). In the study, people struggling with addiction took propranolol, read a personalized passage exploring a drug-using experience, and self-reported cravings. These self-reported craving measurements were repeated bi-weekly for 3 weeks. Research suggests that propranolol can reduce self-reported cravings of people suffering from addiction. It also shows propranolol’s ability to lessen emotions surrounding drug experiences across substance abuse disorders.

So now, you may be thinking, “This sounds too good to be true and far too easy! How does it work?”

Like every treatment plan for substance abuse, propranolol is not a one-stop cure. Other treatments such as psychotherapy should still be emphasized. Still, in tandem with revisiting old drug-experiences, propranolol can interrupt the reconsolidation of memories related to the craving of drugs (Lonergan et al. 2015).

Though propranolol is in the early trial stages as a treatment for addiction, it shows great promise as a method to help people stay sober across different types of abused substances.

So yeah, sobriety is hard and staying sober is even more difficult, but researchers have identified at least one way that might make staying sober a little more manageable.

References

NIDA. (2018, July 20). Drugs, Brains, and Behavior: The Science of Addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction on 2019, April 11

Lonergan, M., Saumier, D., Tremblay, J., Kieffer, B., Brown, T. G., & Brunet, A. (2016). Reactivating addiction-related memories under propranolol to reduce craving: A pilot randomized controlled trial. J Behav Ther Exp Psychiatry, 50, 245-249. doi:10.1016/j.jbtep.2015.09.012

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