Addiction: Can you ever really completely leave it behind?

It is often said that once people develop an addiction, they can never completely eliminate their attraction to the abused substance. New findings provide further support for this notion by suggesting that even long-term abstinence from cocaine does not result in a complete normalization of brain circuitry.

Scientists are currently trying to answer some of the 'chicken and egg' questions surrounding the abuse of drugs. In particular, one of those questions is whether individuals who abuse psychostimulants like cocaine are more impulsive and show alterations in circuits as a consequence of using the drug, or whether such abnormalities existed prior to their drug use. In the former case, one might expect brain alterations to normalize following prolonged drug abstinence.

To address these questions, Krishna Patel at Institute of Living/Hartford Hospital and colleagues compared neural responses between three groups of people who were asked to complete a task that resembles bidding on eBay items.. The 3 groups consisted of 47 healthy controls, 42 currently drug-abusing cocaine users, and 35 former cocaine users who had been abstinent an average of 4 years. They also compared all three groups on their levels of impulsivity and reward responding.

They found that active users showed abnormal activation in multiple involved with reward processing, and that the abstinent individuals who were previously cocaine dependent manifested differences in a subset of those regions. Both current and former cocaine users displayed similarly elevated impulsivity measures compared to healthy controls, which may indicate that these individuals had a pre-existing risk for addiction. Indeed, the degree of impulsivity correlated with several of the abnormalities.

These findings suggest that prolonged abstinence from cocaine may normalize only a subset of the associated with active drug use.

"The knowledge that some neural changes associated with addiction persist despite long periods of abstinence is important because it supports clinical wisdom that recovery from addiction is a lifelong process," says Dr. John Krystal, Editor of Biological Psychiatry. "Further, it is the start of a deeper question: How do these persisting changes develop and how can they be reversed?"

The authors agree that further studies will be needed to investigate such questions, including the continued attempt to determine the extent to which differences in former reflect aspects of pre-existing features, exposure to cocaine, or recovery.

More information: The article is "Robust Changes in Reward Circuitry During Reward Loss in Current and Former Cocaine Users During Performance of a Monetary Incentive Delay Task" by Krishna T. Patel, Michael C. Stevens, Shashwath A. Meda, Christine Muska, Andre D. Thomas, Marc N. Potenza, and Godfrey D. Pearlson (DOI: 10.1016/j.biopsych.2013.04.029). The article appears in Biological Psychiatry, Volume 74, Issue 7 (October 1, 2013)

add to favorites email to friend print save as pdf

Related Stories

Abnormal brain structure linked to chronic cocaine abuse

Jun 21, 2011

Researchers at the University of Cambridge have identified abnormal brain structures in the frontal lobe of cocaine users' brains which are linked to their compulsive cocaine-using behaviour. Their findings were published ...

Weight loss drug helps curb cocaine addictions, study finds

Jul 18, 2013

The drug topiramate, typically used to treat epilepsy and more recently weight loss, may also help people addicted to both cocaine and alcohol use less cocaine, particularly heavy users, researchers in the department of Psychiatry ...

Recommended for you

Mothers don't speak so clearly to their babies

Jan 23, 2015

People have a distinctive way of talking to babies and small children: We speak more slowly, using a sing-song voice, and tend to use cutesy words like "tummy". While we might be inclined to think that we ...

Explainer: What is sexual fluidity?

Jan 23, 2015

Sexual preferences are not set in stone and can change over time, often depending on the immediate situation the individual is in. This has been described as sexual fluidity. For example, if someone identifies as heterosexual but th ...

Lucky charms: When are superstitions used most?

Jan 23, 2015

It might be a lucky pair of socks, or a piece of jewelry; whatever the item, many people turn to a superstition or lucky charm to help achieve a goal. For instance, you used a specific avatar to win a game and now you see ...

Low-income boys fare worse in wealth's shadow

Jan 22, 2015

Low-income boys fare worse, not better, when they grow up alongside more affluent neighbors, according to new findings from Duke University. In fact, the greater the economic gap between the boys and their neighbors, the ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.