Drug Dependence Clinical Trial
Official title:
Automatic Versus Evaluative Components of Cue Reactivity
Background:
- Relapse to drug abuse often happens in the presence of stimuli that are associated with
previous drug use, also known as cues. Drug-taking behavior appears to be partly controlled
by such cues. Some research suggests that cue-induced craving states are responsible for drug
use and relapse, but other research suggests that cues can control drug taking without
conscious craving or even awareness. Researchers are interested in using functional magnetic
resonance imaging (fMRI) to study how individuals respond to drug-related cues and how these
cues affect craving on a conscious or unconscious level.
Objectives:
- To determine how drug-related stimuli (cues) affect thinking, information processing, and
body reactions in current drug users.
Eligibility:
- Individuals between 18 and 50 years of age who are dependent on either tobacco or
crack-cocaine, or are healthy volunteers who are not dependent on either drug.
Design:
- The study will require two sessions, a training session and a testing session, that will
take place within 48 hours of each other. Between the two test sessions, participants
may not consume alcohol, tobacco, or illegal drugs, and must restrict caffeine
consumption.
- During the first session, participants will complete questionnaires about
tobacco/cocaine use and craving, and will be trained on the tasks to be performed in the
MRI scanner.
- During the second session, participants will perform concentration tasks and look at
pictures, some of which will be tobacco/cocaine related. Body reactions such as heart
rate, pupil dilation, and sweating will be measured during this session. Some
participants will have actual MRI scanning, while others will have mock MRI scanning.
- After the MRI session, participants will complete questionnaires about craving and
responses to the scan.
Relapse to drug abuse often happens in the presence of stimuli that are associated with previous drug-use, and drug-taking behavior appears to be partly controlled by such cues. While some theories postulate that such facilitation is mediated by cue-induced craving states, others hypothesize that the underlying processes are highly automatized and can happen without conscious control or even awareness. One way to approach psychological mechanisms of cue reactivity is to measure disruption of ongoing mental activity by drug-related material in dependent individuals while manipulating the degree to which cognitive evaluative processes can unfold. Craving measurement under these conditions can elucidate its relationship with automatic processing versus conscious evaluation of drug cues. Autonomic and neural correlates can be identified by concomitant psychophysiological and fMRI recording. Results from these studies will shed light on the role of spontaneous automatic reactions versus cognitive evaluation for different measures of cue reactivity. By helping to elucidate the psychological mechanisms and neurobiological basis of drug-cue reactivity in dependent individuals, this may have substantial implications for the understanding of mechanisms and treatment of drug dependence. Thus, while there are no direct benefits to subjects participating in these experiments, the results may benefit the health of society. MRI-related risks to subjects (injury from metal implants, claustrophobia, temporary deafness due to the loud banging noises) will be minimized by prescreening and providing earplugs. Drug-related cues may induce acute craving; subjects will be dismissed only after craving levels have returned to baseline. ;
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