If we could make it so drug addicts could stop craving the substances that have brought them to their knees, would relapse rates drop and addiction-treatment success rates soar? I sure hope so!
Medications that stop cravings?
I’ve already written about a study by the renowned addiction researcher Barry Everitt showing that medications could be used in treatment to help addicts who are struggling with strong cravings and the effect of triggers (see it here). Still, in that study the researchers used a drug that blocked pretty much all memory formation and my original idea had to do with using a very common drug, one being used every day for hypertension, and more recently, in the treatment of PTSD.
Well, a study recently completed revealed that indeed, propranolol, a common beta-blocker, may be useful in greatly reducing the amount of time needed to overcome the sometimes crippling effect of triggers on behavior.
How this trigger to cravings study worked
The researchers trained rats to take cocaine, and after they were well trained, allowed them to press a lever for a light that had previously been associated with the drug. This is a common method to test the way animals react to triggers that have been associated with the drug. Even though the animals are no longer getting any cocaine when the light goes on, the fact that it had been previously associated with the drug makes the animals press the lever, like an addict triggered by something they’ve associated with their drug use.
The animals that were given propranolol immediately after every session took half as long to stop pressing for the drug-associated light. It took multiple administrations of propranolol (seven to be exact), but the effect was clear. The next step is to see if the same effect can be observed in people.
Helping addicts transition to outpatient substance abuse treatment
I’ve been claiming for the past few years that if we look in the right places, we can find many ways to help struggling addicts who are having a hard time quitting using currently available methods. I think that the notion that sticking to the “best method we have right now” is unwise given the fact that science has progressed quite a bit in the past 20-30 years. I agree, and am thankful, that the system works for some, but there’s no question that many still have trouble recovering from addictions that devastate their own lives and the lives of many close to them. I think these medications can offer some serious help.
The thing is, that if we could seriously reduce the impact of cravings on relapse rates, it’s possible that addicts would be ready to move from residential to outpatient substance abuse treatment more quickly. Indeed, the main reason for keeping people in residential treatment is the thinking that they’re not ready to be in the world given the influence of triggers. My guess is that this is true for some addicts, but if we could provide an intervention, like propranolol, that would significantly reduce the influence of triggers, outpatient substance abuse treatment, which is a cheaper option, will be useful for many more. This would mean more people in treatment that truly works for them for less money. Sounds good to me.
Citation:
Ashley N. Fricks-Gleason & John F. Marshall (2008). Post-retrieval ß-adrenergic receptor blockade: Effects on extinction and reconsolidation of cocaine-cue memories. Memory & Learning, 15, 643-648
8 responses to “Helping Addicts with medications for cravings”
I absolutely agree with these ideas, that traditional recovery and substance abuse treatments are old fashioned and need updating. We need fresh ideas about recovery and modern technology and medicine need to be a part of that.
It’s not that 12 step programs are ineffective, it’s that they are relatively narrow in focus and therefore limiting. We need a more holistic approach that borrows resources from modern ideas and advancements.
I found your article intriguing, but I wish you would print the researcher/research so that I can read it myself and pass it on to others in the field. Thanks!
Josephine, thanks to your comment I went out and looked for the official citation. When I saw this, it was just a poster at a conference, but the presenter told me it was soon coming out in press, and it did indeed.
I’ve now added the citation to the original post. Hope you enjoy the read!
Adi
[…] More recent studies, using repeated doses of the drug propranolol, have been shown to have an even more promising effect. Check out my coverage of that research here. […]
[…] This post was mentioned on Twitter by Adi Jaffe. Adi Jaffe said: New A3 post: Helping Addicts with medications for cravings http://bit.ly/9vKs3f #addiction #cocaine #Drugs […]
There are many people who believe addicts just don’t want to stop. I know from personal experience that is not so. This article sheds a bit of hope for those who have long suffered. No bullet may be “magic” but a little help is better than none at all. Even if it takes 100 treatments to stop hitting the “Drug-associated-light” sign me up.
Thanks for your comment Erie,
I agree that any tool we can use to make things better should be utilized.
Our clinic is finding that Vivitrol shots are very effective in stopping cravings for alcohol.