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Can Addiction Be Forgotten? The drug propranolol may weaken memories involved in relapse

This is Savannah.

Savannah’s parents introduced her to drugs at age 10.

From then on, she was consuming a cocktail of “downers” and “uppers” at home. Struggling with depression and neglected by her parents, she used drugs as a distraction from her emotions.

Over time, her mind adopted a simple equation: DRUGS = ESCAPE.

Her mind remembered this equation even after the drugs were no longer pleasurable.

Her mind also remembered the places where she usually took the drug and who she took it with.

Just as you associate the sound of the bell with the end of class, or the smell of baking cookies with impending deliciousness, the sights, smells and sounds of previous drug experiences reminded Savannah of that equation, drugs = escape.

These “cues” made her anticipate and crave drugs even more, making the formula cues --> drugs = escape.

Eight years after her addiction began, Savannah became sober, and now she is supporting herself independently. She has begun a new life in a new environment.

However, the cues of the past still threaten to reactivate the drug = escape equation.

Who did she do drugs with? Her parents. Where did she do them? In her parents’ homes. Simply visiting her parents could trigger a relapse.

But what if a pill could take the "cue" out of "cue --> drug = escape"?

Psychiatrist Michelle Lonergan believes that propranolol may be that pill.

“The key is to target memory,” Lonergan says. “Memories of drug-taking link drugs and cues together. People remember the sensation of the drug along with the details of where, how, and with whom they took it."*

"The beauty of memories, however, is that they can change. When memories are recalled, they become temporarily flexible, and they can either be strengthened or weakened. Propranolol weakens memories in this flexible state. So, if people recall a drug-taking experience after consuming propranolol, the memory linking drug with situational cues may be diminished.”*

In Lonergan’s study, ten people in addiction treatment programs wrote about a drug-taking experience in detail, including as many cues as possible. They received propranolol, and then read their narrative aloud to elicit memories of drug-taking.

After six sessions, the participants who took propranolol reported less craving for alcohol, cocaine and opioids than those who did not take the drug. Cues induce craving, so less craving might mean that propranolol weakened the memory of the cues.

Participants who took propranolol reported less craving for alcohol, cocaine and opioids than those who did not take the drug.

So, could propranolol prevent Savannah from relapsing?

The answer is not clear. The study measured changes in overall craving, but not the craving induced by cues specifically. Many of the participants were in residential treatment programs, so they had limited exposure to drug-related cues.

In any case, no drug alone will solve addiction. Savannah’s recovery resulted from the support of counselors, sponsors, and her boyfriend, as well as her own spirituality and strength. Recovery takes a village, and if clinically approved, propranolol will only provide additional support on the journey.

*Fake quotes based on the content of Lonergan’s article, "Reactivating addiction-related memories under propranolol to reduce craving: A pilot randomized controlled trial" published in 2016 in Journal of Behavior Therapy and Experimental Psychiatry.

Created By
Danielle Levinson
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Credits:

Created with images by Siarhei - "Human brain digital illustration. Electrical activity, flashes and lightning on a blue background." • Claudio_Scott - "girl smoke cigarette nicotine woman" • Greta Schölderle Møller - "untitled image" • jarmoluk - "photo photographer old" • Jason Wong - "untitled image" • NeONBRAND - "untitled image" • skeeze - "clasped hands comfort hands" * Phoenix House - "Savannah" 

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