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Individuals with cocaine addiction most vulnerable at months 1, 6 of abstinence

Recent findings indicated individuals with cocaine addiction were most vulnerable to drug cues at 1 month and 6 months of abstinence, suggesting the significance of applying interventions at these time points.

“The neuropsychological mechanisms of relapse remain poorly understood, but include the experience of intense craving for the drug elicited by cues or contexts previously associated with the drug,” Muhammad A. Parvaz, PhD, of Icahn School of Medicine atMount Sinai, New York, and colleagues wrote. “To track human cue-induced craving in a manner akin to the preclinical literature, it may therefore be imperative to measure reactivity to drug-related cues more objectively. The late positive potential component of the clinically translatable electroencephalogram (EEG) is an objective and temporally precise marker of motivated attention to salient stimuli that, in individuals with cocaine use disorders, correlates with subjectively assessed cue-induced craving, predicts simulated drug-seeking behavior, and is modulated by abstinence.”

Muhammad A. Parvaz

To assess cue-induced craving for cocaine in humans, researchers used the late positive potential of EEG to track motivated attention to drug cues among 76 individuals with cocaine addiction and varying durations of abstinence. Study participants completed subjective ratings of cocaine craving before presentation of a cue and cocaine “liking” (ie, hedonic feelings toward cocaine) and “wanting” (ie, craving for cocaine) after presentation of cocaine-related images.

Overall, 25% of the cohort was abstinent for 2 days, 26% were abstinent for 1 week, 20% were abstinent for 1 month, 16% were abstinent for 6 months and 13% were abstinent for 1 year.

Mean late positive potential amplitudes indicated a parabolic trajectory that was higher at 1 and 6 months of abstinence and lower at 2 days, 1 week and 1 year of abstinence (P = .02).

Conversely, subjective assessment of baseline craving, cue-induced liking and wanting of cocaine declined linearly from 2 days to 1 year of abstinence (P .001).

“These clinically significant results highlight 1 month and 6 months of abstinence as the period during which abstaining individuals addicted to controlled substances may be most vulnerable to, and perhaps least cognizant of, the risk of relapse,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.