Craving During Smoking Abstinence: Does it Abate or Incubate?

描述(申请人提供)：复发仍然是药物滥用治疗中最持久和最严重的问题。多达90%试图戒烟的吸烟者最终会复发，吸烟者在急性戒断症状消退后仍有很高的复发风险。虽然复发通常发生在禁欲后不久，但最近对动物的研究表明，在长达6个月的禁欲期间，对条件刺激的寻药反应逐渐增加，这一现象被称为“潜伏期”。虽然线索反应性与动物实验室中的可操作性药物寻找反应密切相关，但在人类中线索反应性和吸毒之间的关系尚未得到牢固的确立。我们建议通过研究吸烟者对吸烟线索的反应性和戒烟不同时期后重新吸烟的时间，以及线索反应性的变化是否与复发时间的变化相关联，来研究这种潜伏现象是否发生在人类吸烟者身上。该项目将在芝加哥大学进行，同时在巴尔的摩的国家药物滥用研究所进行类似的项目。这项研究的目标是：1.评估吸烟者在增加戒烟时间后吸烟-线索反应的“潜伏期”。我们将调查戒烟者在戒烟7天、14天和35天后对吸烟线索的反应性，作为戒烟持续时间的函数。基于对实验动物的研究，假设在较长时间的禁欲后，线索的反应性会更强。2.评估戒烟时间延长后恢复吸烟趋势的“潜伏期”。在通过金钱奖励维持7天、14天或35天的戒烟后，受试者将被允许重新吸烟，而维持戒烟的金钱奖励将逐渐减少。我们试探性地假设，在较长时间的戒烟后，吸烟的潜伏期将会缩短，重新吸烟的可能性将会增加。这是一个将实验室动物的新发现应用到临床环境中的转换项目。这项研究使用了一种创新的方法来调查一种尚未在人类身上表现出特征的现象，但这种现象可能与试图戒毒的吸毒者具有临床相关性。该项目是芝加哥大学基础和临床科学家与NIDA校内研究计划之间独特合作的结果。

DESCRIPTION (provided by applicant): Relapse remains the most persistent and significant problem in drug abuse treatment. As many as 90% of smokers who attempt to quit eventually relapse, and smokers remain at high risk for relapse well after their acute withdrawal symptoms have subsided. Although relapse most commonly occurs soon after abstinence, recent studies with animals indicate that drug-seeking responses to conditioned stimuli gradually increase in magnitude for as long as 6 months of abstinence, a phenomenon known as "incubation". While cue reactivity is closely linked to operant drug-seeking responses in the animal laboratory, the relationship between cue reactivity and drug-taking in humans has not been firmly established. We propose to investigate whether this incubation phenomenon occurs in human cigarette smokers by studying their reactivity to smoking cues and time to relapse to smoking after varying periods of abstinence and whether changes is cue reactivity are associated with changes in time to relapse. The project will be conducted at the University of Chicago, in parallel with a similar project at the National Institute on Drug Abuse Intramural Research Program in Baltimore. The goals of the study are: 1. To assess "incubation" of smoking-cue reactivity after increasing durations of abstinence in cigarette smokers. We will investigate the reactivity to smoking cues among abstinent cigarette smokers, as a function of duration of abstinence after 7, 14, and 35 days of abstinence. Based on the studies with laboratory animals, it is hypothesized that cue reactivity will be greater after longer periods of abstinence. 2. To assess "incubation" of the tendency to resume smoking after increasing durations of abstinence. After 7, 14 or 35 days of abstinence maintained with monetary incentives, subjects will be allowed to return to smoking, with gradually decreasing monetary incentives for maintaining abstinence. We tentatively hypothesize that the latency to smoking will decrease, and the likelihood of returning to smoking will increase, after longer periods of abstinence. This is a translational project that applies novel findings in laboratory animals to a clinical setting. The study uses an innovative procedure to investigate a phenomenon that has not yet been characterized in humans, but which may have clinical relevance for drug users attempting to abstain. The project is the result of a unique collaboration among basic and clinical scientists at the University of Chicago and the NIDA Intramural Research Program.