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Disrupting drug memories a treatment approach for addiction

How many times have you heard yourself saying you are going to quit something, whether it be smoking, video games, diet coke, or whatever you have, but still found yourself back at it later? We all know how hard it is to quit something, especially when it is rewarding, and even worse, addictive.

Indeed, drug addiction is such a chronic, relapsing disorder that 40% to 60% of patients returned to drug use within one year after going through treatment, according to several follow-up studies (as cited in Mclellan et al., 2000). Relapse is the rule rather than exception among people struggling with addiction.

One prominent risk factor for relapse is the presence of cues that have been associated with drug use. Think about this: have you been triggered to get an extra cup of coffee on a sluggish weekday just by the smell of someone else’s coffee?

The cue we associate with a reward, like the smell of coffee, can obtain enough motivational power in and of itself to get us into taking the reward. To see this problem in a new light, disrupting drug-cue associations might be an effective treatment approach to combat the chronic and relapsing nature of drug addiction.

But how would we be able to disrupt such associations that seem to be deeply embedded in our heads?

Actually, the approach might be simpler than you think. It involves a conjunction of giving people propranolol and awakening their drug-related memories. Propranolol, a common heart medicine, can block the strengthening of memories if it is taken before they become long-term memories.

Memory Reconsolidation

To be clear, propranolol is not a memory-wiping pill; it only eases the intensity of memories. It does so by disrupting memory reconsolidation, which is the process that a memory, after it is recalled from our memory storage, requires re-stabilizing for it to become firmly rooted in the memory storage again (Milton& Everitt, 2010).

In a pilot trial by Lonergan et al. (2015), the researchers showed this approach to be quite feasible. They split participants who were dependent on drug or alcohol into two groups: one group would be given propranolol and the other placebo pills.

Each session began by giving the participants a self-report questionnaire to access their severity of alcohol/drug craving. One hour after taking either propranolol or placebo, that is when propranolol was well in effect, both groups were asked to read aloud a detailed narrative of their personal drug-using experiences. In this way, their drug-related memories, which contained numerous cues related to drug use, could be reactivated. Such session was conducted 6 times over a period of 3 weeks.

By the sixth session, subjective craving was significantly lower in the group that had taken propranolol, but not in the group that had taken placebo.

Taking propranolol in conjunction with recalling drug-using memories were able to impair the drug-cue associations and thus reduce drug-craving.
Although it is only a preliminary trial, the simplicity of such approach already seems attractive. Hopefully, it will be able to help more people struggling with the chronic, relapsing drug addiction.

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Created with an image by ShonEjai - "graffiti quote hope"

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