Many studies and investigations have been conducted to test new treatment options and their efficacy in preventing relapse and promoting abstinence. Some of these studies are discussed below. Long periods of abstinence is said to be affected by opioid injections, which cause some rewarding effects (Bozarth & Wise, 1984). Indeed, it is presumed by many investigators, and such conclusion is based on the theory that opioids can relieve the distress of withdrawal consequent to long-term drug use (Bozarth & Wise, 1984).
One study conducted by Bozarth and Wise shows that the rewards provided by opioids are not related to physical dependence on drugs (1984). This conclusion supports the observation that opioids retain their potent rewarding effects even after long periods of drug abstinence (Bozarth & Wise, 1984). The experiment, which was conducted on rats that were administered with morphine to reduce physical dependence on drugs, showed that “at least one rewarding consequence of opioids does not involve the dependence mechanism (Bozarth & Wise, 1984).
” This study provides a relevant theory in drug treatment and treatment outcomes, as it challenges common belief that drug abuse is characterized by physical dependence (Bozarth & Wise, 1984). The finding that relief from withdrawal symptoms are observed, even among subjects that were formerly non-dependent, shows the need to remove the emphasis of theories of addiction on dependence (Bozarth & Wise, 1984).
Moreover, Bozarth and Wise suggest that treatment programs should not be evaluated for efficacy based on the alleviation of withdrawal discomfort (1984). Relapse is a major cause of problem in the rehabilitation of drug abusers (See, Fuchs, Ledford, & McLaughlin, 2003). Applied to drug dependence and treatment, it is defined as “the return to drug-seeking and drug-taking behavior after a prolonged period of abstinence (See, Fuchs, Ledford, & McLaughlin, 2003). ”
Indeed, there are many reports about the high rates of relapse to drug use subsequent to drug detoxification (See, Fuchs, Ledford, & McLaughlin, 2003). Relapse is primarily attributed to the influence of craving, which is an “intense desire for a specific object or experience (See, Fuchs, Ledford, & McLaughlin, 2003). ” Craving is always measured in studies on drug relapse (See, Fuchs, Ledford, & McLaughlin, 2003). However, its precise meaning and role in relapse are still unsettled and subject of debate (See, Fuchs, Ledford, & McLaughlin, 2003).
The role of craving in relapse is even more weakened with the establishment of evidence showing that there could be multifarious internal and external stimuli that could trigger heightened motivation towards relapse or drug-seeking behavior (See, Fuchs, Ledford, & McLaughlin, 2003). For instance, there is an observed correlation between certain environmental cues associated with drugs that are able to elicit drug craving (See, Fuchs, Ledford, & McLaughlin, 2003).
This causes relapse or drug-seeking and drug-taking behavior (See, Fuchs, Ledford, & McLaughlin, 2003). These responses are also observed in people’s craving for other substances, such as alcohol, opiates, and cocaine (See, Fuchs, Ledford, & McLaughlin, 2003). This observation leads to the belief that stimuli that were previously considered neutral acquire incentive-motivational properties due to the process of associative learning (See, Fuchs, Ledford, & McLaughlin, 2003).
This associative learning is a result of repeated pairing of the drug with the neutral stimuli (See, Fuchs, Ledford, & McLaughlin, 2003). This is a helpful theory to drug treatment and treatment outcomes, because it provides conditioned stimuli as an explanation to ongoing drug-seeking behavior and abstinence (See, Fuchs, Ledford, & McLaughlin, 2003). This is in addition to the theory of craving as the motivation for further drug use and relapse (See, Fuchs, Ledford, & McLaughlin, 2003).
Another literature worthy of note is the study conducted by Sinha, Fox, Hong, Sofuoglu, Morgan, and Bergquist. They focused on cocaine dependence and its implications fro women’s susceptibility to experience relapse (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007). In particular, these authors focused on the female part of the population of drug dependents because they observed that women tend to possess “greater subjective levels of distress and a higher heart rate response to stress” than men (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007).
Moreover, these factors are affected by exclusively women’s physiological characteristics and makeup, such as the menstrual cycle and the changing levels of gonadal hormones (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007). Noting studies that conclude that cocaine relapse outcomes are predicted by stress-induced craving for the drug and stress-related HPA responses, Sinha, Fox, Hong, Sofuoglu, Morgan and Bergquist theorized that many factors may influence the development of a stress-related functional state in abstinent cocaine dependent individuals, which is related to their susceptibility to relapse (2007).
This hypothesis is based on previous research data showing that cocaine craving and physiological arousal for the drug are caused or increased by exposure to emotional stress or various forms of drug cues (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007). Moreover, former cocaine dependent individuals who have gone abstinent found themselves increasingly sensitive to stress, which causes craving, negative emotions, anxiety, and cardiovascular arousal for the drug (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007).
Thus, they determined to find out if there is any relevant difference to the causes and treatment of drug dependence based on the sex of the dependents, seeing that there are many possibilities that may be useful in treating drug dependence (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007). One specific example of a difference in drug dependence treatment is the observed lack of efficacy of Disulfram in treating cocaine dependence in women, but the opposite effect is true with men (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007).
After studying nineteen subjects composed of women who were seeking treatment for cocaine dependence, which sample excluded those who were already receiving treatment or medication, the group observed the possible effects of female physiological properties such as the menstrual cycle phase and sex hormones on drug dependence (Sinha, Fox, Hong, Sofuoglu, Morgan & Bergquist, 2007). They utilized subjective measures to determine the level of drug cravings and used the Critikon Dinamap Monitor to assess the pulse and blood pressures of the subjects.