An explanation of why recovering people can't count on being able to see a relapse coming:
The human brain responds to recognizable signals for sex and drugs of addiction by activating the limbic reward circuitry. To determine whether the brain responds in similar ways to these signals even when they are "unseen" -- i.e., presented in a way that prevents their conscious recognition -- researchers in an NIDA-funded study tested the brain response to cocaine, sexual, aversive, and neutral cues (33 milliseconds duration each) in 22 male patients with cocaine dependence. Brain response to each visual cue was measured by magnetic resonance imaging (MRI).
- Cocaine-related images triggered the emotional centers of the brains of patients, even when subjects were unaware they had seen anything.
- Greater brain activity to “unseen” cocaine cues predicted a stronger positive response to visible versions of the same stimuli in later testing.
Comments by Tommie Ann Bower, MA
Results of this study supports years of anecdotal evidence that relapse can be triggered outside of awareness. As with any new finding, the generalizability of these results will depend on additional studies. In the long run, the complicated nature of craving in the brain must be further understood. In the short run, clinicians must redouble efforts to educate patients about the specific triggers for craving, to activate awareness, and to redirect impulses to use.
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