Neurobiology of cognition and craving in opiate addiction: implications for relapse

Abstract

High rates of relapse are a key challenge in the treatment of opiate addiction. This project aims to bring new clinical and neuroscientific expertise to bear on the problem of understanding and preventing relapse. The aim is to establish identify brain mechanisms that are associated with risk of relapse in recently de-toxified heroin addicts. Participants will be exposed to a video that reliably elicits subjective craving, during MRI scanning. Our novel phMRI analysis methods will enable us to follow the direct effects of craving on regional brain function and then investigate how craving modulates cognitive function. 40 opiate addicts will be recruited from an inpatient treatment programme and will be scanned as they complete the programme, just prior to discharge. At this stage, subjects will be abstinent from drugs and not taking maintenance medications. Subjects will be scanned twice at an interval of 48-72 hours to compare the effects of a craving video with a neutral video. A group of matched control subjects will be scanned using the same protocol. This will allow us to identify neuronal correlates of acute craving in opiate addicts, and the modulation of cognitive function by craving. The detoxified addicts will be monitored for 3 months following discharge from treatment to determine whether or not they relapse within this period. We will perform a post-hoc comparison between relapsing and abstinent patients to determine whether any of the neuronal indices represent potential biomarkers for relapse. This research will provide a basis for the use of imaging and cognitive biomarkers to detect the efficacy of novel pharmacological and psychological interventions to prevent relapse in opiate addicts.

Duration of the project

September 2009-August 2011

Funding body

Medical Research Council (MRC)