A Memory Retrieval-Extinction Procedure to Prevent Drug Craving and Relapse

TLDR

Drug relapse is driven by learned associations between environmental cues and drug effects, and although extinction can suppress conditioned responses, these responses often return via reinstatement, renewal, or spontaneous recovery. The study proposes a memory retrieval‑extinction procedure to reduce conditioned drug effects and drug seeking in rat models of relapse and to diminish craving in abstinent heroin addicts. In rats, retrieval 10 minutes or 1 hour before extinction attenuated reinstatement, spontaneous recovery, and renewal, while in heroin addicts retrieval 10 minutes before extinction lowered cue‑induced craving at 1, 30, and 180 days, demonstrating the procedure as a promising nonpharmacological method to reduce craving and relapse.

Abstract

Drug use and relapse involve learned associations between drug-associated environmental cues and drug effects. Extinction procedures in the clinic can suppress conditioned responses to drug cues, but the extinguished responses typically reemerge after exposure to the drug itself (reinstatement), the drug-associated environment (renewal), or the passage of time (spontaneous recovery). We describe a memory retrieval-extinction procedure that decreases conditioned drug effects and drug seeking in rat models of relapse, and drug craving in abstinent heroin addicts. In rats, daily retrieval of drug-associated memories 10 minutes or 1 hour but not 6 hours before extinction sessions attenuated drug-induced reinstatement, spontaneous recovery, and renewal of conditioned drug effects and drug seeking. In heroin addicts, retrieval of drug-associated memories 10 minutes before extinction sessions attenuated cue-induced heroin craving 1, 30, and 180 days later. The memory retrieval-extinction procedure is a promising nonpharmacological method for decreasing drug craving and relapse during abstinence.