Studies into Relapse

Last Updated: Sep 20th 2019

Reviewed by Brittany Polansky, MSW, LCSW

Arguably the most difficult period of substance use disorder treatment isn’t the process of rehab in a treatment facility, but trying to not relapse after leaving the center. In fact, one of the most common thing patients treated for addictions don’t realize until they’re in treatment is that it is considered a chronic illness specifically for this very reason. The sometimes daily struggle against cravings can be challenging if not outright terribly difficult and claims thousands of recovering addicts a year, sometimes costing them their life. While relapse does not mean that treatment has failed, it is still a responsibility that often goes understated.

The University of Pennsylvania Epigenetics Institute’s Elizabeth Heller, Ph.D. has taken an interest in this part of addiction and why relapse is so common even when all traces and access to the drug is minimized or eliminated. Heller’s hypothesis is that understanding the persistent nature of the symptoms of drug abuse even during abstinence requires consideration of epigenetic changes caused by the drugs themselves.  

Dr. Heller explains, “Without changing the actual sequence of DNA, we have mechanisms in our body to control how and when cells express certain genes. These mechanisms are influenced by changes in our environment, and the process of influencing gene expression without altering the basic genetic code is called epigenetics.” To put it another way, without changing the actual sequence of DNA, there are mechanisms in the body to control how and when to express certain genes which are often influenced by things like the environment.

Heller’s most recent research went into the effects of cocaine addiction in relation to epigenetics. Of note, the FosB gene, an already suspected as responsible in addiction behaviors. The findings of the study showed that cocaine depletes the protein that helps regulate and attenuate response to use of the drug, contributing to it’s addictive properties. In addiction to FosB, Nr4a1 is hijacked by drug use, which is important in dopamine release.

Where this crosses over with cancer research, mice were administered a drug used in cancer treatments that suppresses Nr4a1. The tests revealed that mice who had taken the drug were far more likely to resist the normal environmental cues that normally trigger them to seek and use the provided cocaine. What was noticed more, though, was that the changes in gene expression of both were stronger when the mice were not using the drug, suggesting how and why relapse is so common in chronic cocaine abuse after initial detox and treatment.

As research continues, the specific changes that occur with drug use can possibly be prevented, where one might imagine a ‘cocaine vaccine’ or similar drug resulting from these studies to reverse what cocaine does to your brain.

Before someone can worry about relapse, they require treatment first at centers like First Step in Pompano Beach. Give us a call today to speak with our staff about treatment options.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky, MSW, LCSW

Brittany has been working in behavioral health since 2012 and is the Assistant Clinical Director at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.