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Disrupting Drug Memories
In drug recovery programs, conditioned responses to drug cues can be inhibited by extinction protocols. However, extinguished behavioral responses can return after renewed exposure to the drug itself, or to drug-associated paraphernalia, and sometimes these responses reemerge spontaneously. Attempts have been made to disrupt cue-memory reconsolidation or to strengthen extinction learning, but these efforts have often relied on pharmacological agents that either are not approved for human use or cause problematic side effects. Xue et al. (p. 241; see the Perspective by Milton and Everitt) have tried to circumvent the limitations of pharmacological approaches in daily retrieval trials conducted in rats within the short timeframe of the “reconsolidation window” before the extinction sessions reduced drug-induced reinstatement, spontaneous recovery, and renewal of drug seeking. When translated to heroin-addicted humans, similar retrieval trials before extinction sessions impaired cue-induced heroin craving up to 6 months later. This retrieval-extinction procedure is thus a promising non-pharmacological treatment for addiction.
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.