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Urgency of Drug-Seeking Habit, Not Drug Itself, Drives Addiction Relapse
Ingrained habits in individuals with substance use disorder (SUD) appear to contribute to the perpetuation of drug-seeking behavior and relapse rather than the drug itself, suggests a study involving rats published in Biological Psychiatry. The study supports the idea that substance addiction is a psychiatric disorder.
Researchers explained that SUD involves not only using addictive drugs but also the process of foraging for the drug over long periods of time. Compulsive behaviors characteristic of SUD emerge during the foraging process.
“Therefore,” said study senior author David Belin, PhD, “we found it important to consider the psychological and neural mechanisms of the tendency to inflexibly engage in drug-seeking behaviors, which may reflect the development of maladaptive drug-seeking habits.”
The study involved rats, some of which were trained to seek cocaine under the influence of conditioned reinforcing properties of drug-paired cues. Researchers investigated whether the tendency to relapse after periods of abstinence depended on the aversive state of withdrawal or the loss of opportunity to take part in the ingrained drug-seeking response.
They found that drug-paired cues maintained and invigorated drug foraging over longer periods. Simply put, engagement in foraging behavior became satisfying in itself. Researchers believe the finding holds true for both rats and people.
“When they are prevented from enacting their drug-seeking behavior, in conditions for instance like incarceration in humans, individuals experience the building of internal distress that results in explosive behavior at relapse, which is mediated by so-called ‘negative urgency,’ ” said Dr Belin.
The subsequent fulfilment of the drug-seeking habit, rather than the drug itself, provides relief, according to the study. Consequently, such emotional negative urgency can be considered a risk factor for addiction relapse.
“There has been a historic focus on negative emotional states as a trigger for relapse to substance use. Most of the focus on negative emotions has been directed to comorbid anxiety and mood disorders,” said John Krystal, MD, editor of Biological Psychiatry. “Here, the authors point to negative emotional urgency related to the inability to execute the habit as an important new risk mechanism.”
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