Skip to main content

Advertisement

SpringerLink
Log in

The reinstatement model and relapse prevention: a clinical perspective

  • Commentary
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

Objectives

This commentary assesses the degree to which the reinstatement model is homologous to the human experience of relapse.

Results

A review of the literature suggests that the relationship is less clear than is often assumed, largely due to a lack of prospective data on the precipitants and process of relapse (especially relapse to heroin or cocaine abuse). However, reinstatement does not need to resemble relapse to have immediate clinical value; predictive validity as a medication screen would be sufficient. Whether the model has predictive validity is unknown, because, to date, very few clinical trials have tested medications that are effective in the reinstatement model, and even fewer have used designs comparable to those of reinstatement experiments. A clinical trial comparable to a reinstatement experiment would enroll participants who are already abstinent, and its main outcome measure would be propensity to undergo a specific type of relapse (e.g., relapse induced by stress or cues).

Conclusions

Until clinical and preclinical work are more comparable, criticisms of the reinstatement model's presumed shortcomings are premature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. In this commentary, lapse indicates any use of a drug by an individual who has been abstaining from that drug; relapse indicates a return to compulsive or harmful patterns of use. Operational definitions of these terms vary across studies

  2. The alcohol literature also includes at least two relapse-prevention trials using acamprosate (Sass et al. 1996; Tempesta et al. 2000), which has been screened (with positive results) in the alcohol-deprivation model (Spanagel et al. 1996; Holter et al. 1997; Heyser et al. 1998). The alcohol-deprivation model differs from the reinstatement model in that there is no operant extinction procedure and alcohol is available again during the postdeprivation session (Lê and Shaham 2002)

  3. ABT-431 and ecopipam are, respectively, an agonist and an antagonist at D1 receptors. The seeming paradox of their common effectiveness is discussed by Alleweireldt et al. (2002)

  4. The EMA study by Freedman et al. (2002) focused on the feasibility of issuing and recovering equipment; no data on the process of relapse were reported

  5. This suggested model is admittedly unsatisfying in several respects. The most obvious is that most animals would continue to self-administer some amount of drug throughout the experiment, thus sacrificing one of the major strengths of the reinstatement model: its ability to separate drug-seeking behavior from the pharmacological effects of the drug. The suggested model would also be unsuitable for assessment of priming-induced reinstatement. Still, this line of research could be useful for determining whether reinstatement in laboratory animals differs depending on the circumstances of cessation

References

  • Alleweireldt AT, Weber SM, Kirschner KF, Bullock B, Neisewander JL (2002) Blockade or stimulation of D1 dopamine receptors attenuates cue reinstatement of cocaine-seeking behavior in rats. Psychopharmacology 159:284–293

    Article  CAS  PubMed  Google Scholar 

  • Baker DA, Tran-Nguyen TL, Fuchs RA, Neisewander JL (2001) Influence of individual differences and chronic fluoxetine treatment on cocaine-seeking behavior in rats. Psychopharmacology 155:18–26

    Article  CAS  PubMed  Google Scholar 

  • Bergman J, Katz JL (1998) Behavioral pharmacology of cocaine and the determinants of abuse liability. In: Higgins ST, Katz JL (eds) Cocaine abuse: Behavior, pharmacology, and clinical applications. Academic Press, San Diego, pp 51–79

  • Bespalov AY, Zvartau EE, Balster RL, Beardsley PM (2000) Effects of N-methyl-D-aspartate receptor antagonists on reinstatement of cocaine-seeking behavior by priming injections of cocaine or exposures to cocaine-associated cues in rats. Behav Pharmacol 11:37–44

    Article  CAS  PubMed  Google Scholar 

  • Brady KT, Myrick H, Henderson S, Coffey SF (2002) The use of divalproex in alcohol relapse prevention: a pilot study. Drug Alcohol Depend 67:323–330

    Article  CAS  PubMed  Google Scholar 

  • Campbell UC, Lac ST, Carroll ME (1999) Effects of baclofen on maintenance and reinstatement of intravenous cocaine self-administration in rats. Psychopharmacology 143:209–214

    Article  CAS  PubMed  Google Scholar 

  • Ciccocioppo R, Sanna PP, Weiss F (2001) Cocaine-predictive stimulus induces drug-seeking behavior and neural activation in limbic brain regions after multiple months of abstinence: reversal by D(1) antagonists. Proc Natl Acad Sci USA 98:1976–1981

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ciccocioppo R, Martin-Fardon R, Weiss F (2002) Effect of selective blockade of μ1 or δ opioid receptors on reinstatement of alcohol-seeking behavior by drug-associated stimuli in rats. Neuropsychopharmacology 27:391-399

    Article  CAS  PubMed  Google Scholar 

  • Comer SD, Lac ST, Curtis LK, Carroll ME (1993) Effects of buprenorphine and naltrexone on reinstatement of cocaine-reinforced behavior. J Pharmacol Exp Ther 267:1470–1477

    CAS  PubMed  Google Scholar 

  • Compton PA, Ling W, Charuvastra VC, Wesson DR (1995) Buprenorphine as a pharmacotherapy for cocaine abuse: a review of the evidence. J Addict Dis 14:97–114

    Article  CAS  PubMed  Google Scholar 

  • CRISP Database Of Federally Funded Biomedical Research Projects (2003) http://crisp.cit.nih.gov. Cited 13 Feb 2003

  • Crombag H, Grimm JW, Shaham Y (2002) Effect of dopamine receptor antagonists on renewal of cocaine seeking by re-exposure to drug-associated contextual cues. Neuropsychopharmacology 27:1006–1015

    Article  CAS  PubMed  Google Scholar 

  • De Vries TJ, Shaham Y, Homberg JR, Crombag H, Schuurman K, Dieben J, Vanderschuren LJ, Schoffelmeer AN (2001) A cannabinoid mechanism in relapse to cocaine seeking. Nat Med 7:1151–1154

    Article  Google Scholar 

  • Erb S, Shaham Y, Stewart J (1998) The role of corticotropin-releasing factor and corticosterone in stress- and cocaine-induced relapse to cocaine seeking in rats. J Neurosci 18:5529–5536

    CAS  PubMed  Google Scholar 

  • Erb S, Hitchcott PK, Rajabi H, Mueller D, Shaham Y, Stewart J (2000) Alpha-2 adrenergic agonists block stress-induced reinstatement of cocaine seeking. Neuropsychopharmacology 23:138–150

    Article  CAS  PubMed  Google Scholar 

  • Ettenberg A, MacConell LA, Geist TD (1996) Effects of haloperidol in a response-reinstatement model of heroin relapse. Psychopharmacology 124:205–210

    Article  CAS  PubMed  Google Scholar 

  • Freedman M, Pulley L, Abdolrussa B, McNamara C, Milby J, Schumacher J (2002) Ecological momentary assessment of crack cocaine relapse risk. In: 64th annual scientific meeting of the college on problems of drug dependence, San Juan, Puerto Rico. http://biopsych.com:81/cpdd02_web. Cited 13 Feb 2003

  • Gallin JI, Gottesman MM (2003) Bench-to-bedside awards. National Institutes of Health, Bethesda, MD. http://www.cc.nih.gov/ccc/btb/awards.html. Cited 10 March 2003

  • Gosnell BA (2000) The effects of sucrose availability on the reinstatement of cocaine-seeking. Soc Neurosci Abstr 485.16

    Google Scholar 

  • Gottlieb LD, Horwitz RI, Kraus ML. Segal SR, Viscoli CM (1994) Randomized controlled trial in alcohol relapse prevention: role of atenolol, alcohol craving, and treatment adherence. J Subst Abuse Treat 11:253–258

    Article  CAS  PubMed  Google Scholar 

  • Grimm JW, Hope BT, Wise RA, Shaham Y (2001) Neuroadaptation: incubation of cocaine craving after withdrawal. Nature 412:141–142

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Grottick AJ, Fletcher PJ, Higgins GA (2000) Studies to investigate the role of 5-HT2C receptors on cocaine and food maintained behaviour. J Pharmacol Exp Ther 295:1183–1191

    CAS  PubMed  Google Scholar 

  • Gruber K, Chutuape MA, Stitzer ML (2000) Reinforcement-based intensive outpatient treatment for inner city opiate abusers: a short-term evaluation. Drug Alcohol Depend 57: 211–223

    Article  CAS  PubMed  Google Scholar 

  • Hall SM, Havassy BE, Wasserman DA (1991) Effects of commitment to abstinence, positive moods, stress, and coping on relapse to cocaine use. J Cons Clin Psychol 59: 526–532

    Article  CAS  Google Scholar 

  • Handelsman L, Rosenblum A, Palij M, Magura S, Foote J, Lovejoy M, Stimmel B (1997) Bromocriptine for cocaine dependence: a controlled clinical trial. Am J Addict 6: 54–64

    CAS  PubMed  Google Scholar 

  • Haney M, Collins ED, Ward AS, Foltin RW, Fischman MW (1999) Effect of a selective dopamine D1 agonist (ABT-431) on smoked cocaine self-administration in humans. Psychopharmacology 143:102–110

    Article  CAS  PubMed  Google Scholar 

  • Haney M, Ward AS, Foltin RW, Fischman MW (2001) Effects of ecopipam, a selective dopamine D1 antagonist, on smoked cocaine self-administration by humans. Psychopharmacology 155:330–337

    Article  CAS  PubMed  Google Scholar 

  • Hays JT, Hurt RD, Rigotti NA, Niaura R, Gonzales D, Durcan MJ, Sachs DPL, Wolter TD, Buist AS, Johnston JA, White JD (2001) Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation: a randomized, controlled trial. Ann Intern Med 135:423–433

    Article  CAS  PubMed  Google Scholar 

  • Heyser CJ, Schulteis G, Durbin P, Koob GF (1998) Chronic acamprosate eliminates the alcohol deprivation effect while having limited effects on baseline responding for ethanol in rats. Neuropsychopharmacology 18:125–133

    Article  CAS  PubMed  Google Scholar 

  • Highfield D, Yap J, Grimm J, Shalev U, Shaham Y (2001) Repeated lofexidine treatment attenuates stress-induced, but not drug cues-induced reinstatement of a heroin-cocaine mixture (speedball) seeking in rats. Neuropsychopharmacology 25:320–331

    Article  CAS  PubMed  Google Scholar 

  • Hiller ML (1996) Correlates of recidivism and relapse for parolees who received in-prison substance abuse treatment in Texas. In: Dissertation abstracts international: Section b: The sciences and engineering, vol 57(4-B):2866 Univ Microfilms International, USA

  • Holter SM, Landgraf R, Zieglgansberger W, Spanagel R (1997) Time course of acamprosate action on operant ethanol self-administration after ethanol deprivation. Alcohol Clin Exp Res 21:862–868

    Article  CAS  PubMed  Google Scholar 

  • Khroyan TV, Barrett-Larimore RL, Rowlett JK, Spealman RD (2000) Dopamine D1- and D2-like receptor mechanisms in relapse to cocaine-seeking behavior: effects of selective antagonists and agonists. J Pharmacol Exp Ther 294:680–687

    CAS  PubMed  Google Scholar 

  • Kosten TS, Oliveto A, Sevarino KA, Gonsai K, Feingold A (2002) Ketoconazole increases cocaine and opioid use in methadone maintained patients Drug Alcohol Depend 66:173–180

    CAS  PubMed  Google Scholar 

  • Kranzler HR, Burleson JA, Korner P, Del Boca FK, Bohn MJ, Brown J, Liebowitz N (1995) Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry 152:391–397

    Article  CAS  PubMed  Google Scholar 

  • Lando HA, Valanis BG, Lichtenstein E, Curry SJ, McBride CM, Pirie PL, Grothaus LC (2001) Promoting smoking abstinence in pregnant and postpartum patients: a comparison of 2 approaches. Am J Manag Care 7:685–693

    CAS  PubMed  Google Scholar 

  • Latt NC, Jurd S, Houseman J, Wutzke SE (2002) Naltrexone in alcohol dependence: a randomised controlled trial of effectiveness in a standard clinical setting. Med J Australia 176:530–534

    PubMed  Google Scholar 

  • Lê AD, Poulos CX, Harding S, Watchus J, Juzytsch W, Shaham Y (1999) Effects of naltrexone and fluoxetine on alcohol self-administration and reinstatement of alcohol seeking induced by priming injections of alcohol and exposure to stress. Neuropsychopharmacology 21:435–444

    Article  PubMed  Google Scholar 

  • Lê AD, Shaham Y (2002) Neurobiology of relapse to alcohol in rats. Pharmacol Therapeut 94:137–156

    Article  Google Scholar 

  • Lindblom N, De Villiers SH, Kalayanov G, Gordon S, Johansson AM, Svensson TH (2002) Active immunization against nicotine prevents reinstatement of nicotine-seeking behavior in rats. Respiration 69:254–260

    Article  CAS  PubMed  Google Scholar 

  • Ling W, Shoptaw S, Majewska D (1998) Baclofen as a cocaine anti-craving medication: a preliminary clinical study. Neuropsychopharmacology 18:403–404

    Article  CAS  PubMed  Google Scholar 

  • Litt MD, Cooney NL, Morse P (1998) Ecological Momentary Assessment (EMA) with treated alcoholics: methodological problems and potential solutions. Health Psychol 17:48–52

    Article  CAS  PubMed  Google Scholar 

  • Litt MD, Cooney NL, Morse P (2000) Reactivity to alcohol-related stimuli in the laboratory and in the field: predictors of craving in treated alcoholics. Addiction 95:889–900

    Article  CAS  PubMed  Google Scholar 

  • Liu X, Weiss F (2002a) Reversal of ethanol-seeking behavior by D1 and D2 antagonists in an animal model of relapse: differences in antagonist potency in previously ethanol-dependent versus nondependent rats. J Pharmacol Exp Ther 300:882–889

    Article  CAS  PubMed  Google Scholar 

  • Liu X, Weiss F (2002b) Additive effect of stress and drug cues on reinstatement of ethanol seeking: exacerbation by history of dependence and role of concurrent activation of corticotropin-releasing factor and opioid mechanisms. J Neurosci 22:7856–7861

    CAS  PubMed  Google Scholar 

  • Longo LP (2002) Olanzapine for cocaine craving and relapse prevention in 2 patients. J Clin Psychiatry 63:595–596

    Article  PubMed  Google Scholar 

  • Longo LP, Campbell T, Hubatch S (2002) Divalproex sodium (Depakote) for alcohol withdrawal and relapse prevention. J Addictive Diseases 21:55–64

    Article  Google Scholar 

  • Lukas SE, Stull M, Cowan RL (2002) Polydrug abuse patterns with MDMA (Ecstasy) among young adults. Drug Alcohol Depend 66(suppl 1):S107

    Article  Google Scholar 

  • Mantsch JR, Goeders NE (1999a) Ketoconazole does not block cocaine discrimination or the cocaine-induced reinstatement of cocaine-seeking behavior. Pharmacol Biochem Behav 64:65–73

    Article  CAS  PubMed  Google Scholar 

  • Mantsch JR, Goeders NE (1999b) Ketoconazole blocks the stress-induced reinstatement of cocaine-seeking behavior in rats: relationship to the discriminative stimulus effects of cocaine. Psychopharmacology 142:399–407

    Article  CAS  PubMed  Google Scholar 

  • Margolin A, Avants SK, Kosten TR (1995) Mazindol for relapse prevention to cocaine abuse in methadone-maintained patients. Am J Drug Alcohol Abuse 21:469–481

    Article  CAS  PubMed  Google Scholar 

  • Marlatt AG (1996) Models of relapse and relapse prevention: a commentary. Exp Clin Psychopharmacol 4:55–60

    Article  Google Scholar 

  • Martin-Fardon R, Ciccocioppo R, Massi M, Weiss F (2000) Nociceptin prevents stress-induced ethanol, but not cocaine-seeking behavior in rats. Neuroreport 11:1939–1943

    Article  CAS  PubMed  Google Scholar 

  • McBride CM, Curry SJ, Lando HA, Pirie PL, Grothaus LC, Nelson JC (1999) Prevention of relapse in women who quit smoking during pregnancy. Am J Public Health 89:706–711

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McCrady BS, Epstein EE, Hirsch LS (1999) Maintaining change after conjoint behavioral alcohol treatment for men: outcomes at 6 months. Addiction 94:1381–1396

    Article  CAS  PubMed  Google Scholar 

  • McElroy SL, Weiss RD, Mendelson JH, Teoh SK, McAfee B, Mello NK (1989) NIDA Research Monograph 95:57–63

    CAS  PubMed  Google Scholar 

  • McKay JR, Alterman AI, Cacciola JS, Rutherford MJ, O'Brien CP, Koppenhaver J (1997) Group counseling versus individualized relapse prevention aftercare following intensive outpatient treatment for cocaine dependence: initial results. J Cons Clin Psychol 65:778–788

    Article  CAS  Google Scholar 

  • McMahon RC (2001) Personality, stress, and social support in cocaine relapse prediction. J Subst Abuse Treat 21:77–87

    Article  CAS  PubMed  Google Scholar 

  • Montoya ID, Gorelick DA, Preston KL, Umbricht A, Cheskin L, Contoreggi C, Johnson RE, Fudala PJ (1996) Buprenorphine for treatment of dually-dependent (opiate and cocaine) individuals. NIDA Research Monograph 162:178

    Google Scholar 

  • Montoya ID, Preston KL, Rothman R, Gorelick DA (2002) Open-label pilot study of bupropion plus bromocriptine for treatment of cocaine dependence. Am J Drug Alc Abuse 28:189–196

    Article  Google Scholar 

  • Nader MA, Woolverton WL (1991) Effects of increasing the magnitude of an alternative reinforcer on drug choice in a discrete-trials choice procedure. Psychopharmacology 105:169–174

    Article  CAS  PubMed  Google Scholar 

  • Niaura R, Abrams DR, Shadel WG, Rohsenow DJ, Monti PM, Sirota AD (1999) Addiction 94:685–695

    Article  CAS  PubMed  Google Scholar 

  • Norman AB, Norman MK, Hall JF, Tsibulsky VL (1999) Priming threshold: a novel quantitative measure of the reinstatement of cocaine self-administration. Brain Res 831:165–174

    Article  CAS  PubMed  Google Scholar 

  • Romach MK, Glue P,Kampman K, Kaplan HL, Somer GR, Poole S, Clarke L, Coffin V, Cornish J, O'Brien CP, Sellers EM (1999) Attenuation of the euphoric effects of cocaine by the dopamine D1/D5 antagonist ecopipam (SCH 39166). Arch Gen Psychiat 56:1101–1106

    Article  CAS  PubMed  Google Scholar 

  • Sarter M, Hagan J, Dudchenko P (1992) Behavioral screening for cognition enhancers: from indiscriminate to valid testing: part 1. Psychopharmacology 107:144–159

    Article  CAS  PubMed  Google Scholar 

  • Sarter M, Bruno JP (2002) Animal models in biological psychiatry. In: D'haenen H, den Boer JA, Willner P (eds) Biological psychiatry. Wiley, New York, pp 37–44

  • Sass H, Soyka M, Mann K, Zieglgansberger W (1996) Relapse prevention by acamprosate: results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiat 53:673–680

    Article  CAS  PubMed  Google Scholar 

  • Schenk S (2000) Effects of the serotonin 5-HT(2) antagonist, ritanserin, and the serotonin 5-HT(1A) antagonist, WAY 100635, on cocaine-seeking in rats. Pharmacol Biochem Behav 67:363–369

    Article  CAS  PubMed  Google Scholar 

  • Schenk S, Partridge B, Shippenberg TS (1999) U69593, a kappa-opioid agonist, decreases cocaine self-administration and decreases cocaine-produced drug-seeking. Psychopharmacology 144:339–346

    Article  CAS  PubMed  Google Scholar 

  • Schottenfeld RS, Pakes JR, Oliveto A, Ziedonis D, Kosten TR (1997) Buprenorphine vs methadone maintenance treatment for concurrent opioid dependence and cocaine abuse. Arch Gen Psychiat 54:713–720

    Article  CAS  PubMed  Google Scholar 

  • Schmidt LG, Kuhn S, Smolka M, Schmidt K, Rommelspacher H (2002) Lisuride, a dopamine D2 receptor agonist, and anticraving drug expectancy as modifiers of relapse in alcohol dependence. Prog Neuro-Psychopharmacol Biol Psych 26:209–217

    Article  CAS  Google Scholar 

  • Schmitz JM, Stotts AL, Rhoades HM, Grabowski J (2001) Naltrexone and relapse prevention treatment for cocaine-dependent patients. Addict Behav 26:167–180

    Article  CAS  PubMed  Google Scholar 

  • See RE, Kruzich PJ, Grimm JW (2001) Dopamine, but not glutamate, receptor blockade in the basolateral amygdala attenuates conditioned reward in a rat model of relapse to cocaine-seeking behavior. Psychopharmacology 154:301–310

    Article  CAS  PubMed  Google Scholar 

  • Self DW, Barnhart WJ, Lehman DA, Nestler EJ (1996) Opposite modulation of cocaine-seeking behavior by D1- and D2-like dopamine receptor agonists. Science 271:1586–1589

    Article  CAS  PubMed  Google Scholar 

  • Self DW, Karanian DA, Spencer JJ (2000) Effects of the novel D1 dopamine receptor agonist ABT-431 on cocaine self-administration and reinstatement. Ann NY Acad Sci 909:133–144

    Article  CAS  PubMed  Google Scholar 

  • Shaham Y, Stewart J (1996) Effects of opioid and dopamine receptor antagonists on relapse induced by stress and re-exposure to heroin in rats. Psychopharmacology 125:385–391

    Article  CAS  PubMed  Google Scholar 

  • Shaham Y, Funk D, Erb S, Brown TJ, Walker CD, Stewart J (1997) Corticotropin-releasing factor, but not corticosterone, is involved in stress-induced relapse to heroin-seeking in rats. J Neurosci 17:2605–2614

    CAS  PubMed  Google Scholar 

  • Shaham Y, Erb S, Leung S, Buczek Y, Stewart J (1998) CP-154,526, a selective, non peptide antagonist of the corticotropin-releasing factor type 1 receptor attenuates stress-induced relapse to drug seeking in cocaine-and heroin-trained rats. Psychopharmacology 137:184–190

    Article  CAS  PubMed  Google Scholar 

  • Shaham Y, Highfield D, Delfs JM, Leung S, Stewart J (2000) Clonidine blocks stress-induced reinstatement of heroin seeking in rats: an effect independent of the locus coeruleus noradrenergic neurons. Eur J Neurosci 12:292–302

    Article  CAS  PubMed  Google Scholar 

  • Shaham Y, Shalev U, Lu L, de Wit H, Stewart J (2003) The reinstatement model of drug relapse: history, methodology and major findings. Psychopharmacology DOI 10.1007/s00213-002-1224-x

  • Shalev U, Yap J, Shaham Y (2001) Leptin attenuates food deprivation-induced relapse to heroin seeking. J Neurosci 21:RC129

    CAS  PubMed  Google Scholar 

  • Shalev U, Grimm JW, Shaham Y (2002) Neurobiology of relapse to heroin and cocaine: a review. Pharmacol Rev 54:1-42

    Article  CAS  PubMed  Google Scholar 

  • Shiffman S, Paty JA, Gnys M, Kassel JD, Hickcox M (1996) First lapses to smoking: within-subjects analysis of real-time reports. J Cons Clin Psychol 64:366–379

    Article  CAS  Google Scholar 

  • Shiffman S, Hufford M, Hickcox M, Paty JA, Gnys M, Kassel JD (1997) Remember that? a comparison of real-time versus retrospective recall of smoking lapses. J Cons Clin Psychol 65:292–300

    Article  CAS  Google Scholar 

  • Sidman M (1960) Tactics of scientific research: evaluating experimental data in psychology. Basic Books, New York

    Google Scholar 

  • Spanagel R, Holter SM, Allingham K, Landgraf R (1996) Acamprosate and alcohol: 1. effects on alcohol intake following alcohol deprivation in the rat. Eur J Pharmacol 305:39–44

    Article  CAS  PubMed  Google Scholar 

  • Spanagel R, Sillaber A, Zieglgansberger W, Corrigall WA, Stewart J, Shaham Y (1998) Acamprosate suppresses the expression of morphine-induced sensitization in rats but does not affect heroin self-administration or relapse. Psychopharmacology 139:391–401

    Article  CAS  PubMed  Google Scholar 

  • Streeton C, Whelan G (2001) Naltrexone, a relapse prevention maintenance treatment of alcohol dependence: a meta-analysis of randomized controlled trials. Alcohol Alcoholism 36:544–552

    Article  CAS  PubMed  Google Scholar 

  • Tempesta E, Janiri L, Bignamini A, Chabac S, Potgieter A (2000) Acamprosate and relapse prevention in the treatment of alcohol dependence: a placebo-controlled study. Alcohol Alcoholism 35:202–209

    Article  CAS  PubMed  Google Scholar 

  • Teoh SK, Mello NK, Mendelson JH, Kuehnle J, Gastfriend DR, Rhoades E, Sholar W (1994) Buprenorphine effects on morphine- and cocaine-induced subjective responses by drug-dependent men. J Clin Psychopharmacol 14:15–27

    Article  CAS  PubMed  Google Scholar 

  • Wasserman DA, Weinstein MG, Havassy BE, Hall SM (1998) Factors associated with lapses to heroin use during methadone maintenance. Drug Alcohol Depend 52:183–192

    Article  CAS  PubMed  Google Scholar 

  • Weiss RD, Griffin ML, Hufford C (1995) Craving in hospitalized cocaine abusers as a predictor of outcome. Am J Drug Alc Abuse 21:289–301

    Article  CAS  Google Scholar 

  • Widom CS, Weiler BL, Cottler LB (1999) Childhood victimization and drug abuse: a comparison of prospective and retrospective findings. J Cons Clin Psychol 67:867–880

    Article  CAS  Google Scholar 

  • Wiesbeck GA, Weijers HG, Chick J, Naranjo CA, Boening J (1999) Ritanserin in relapse prevention in abstinent alcoholics: results from a placebo-controlled double-blind international multicenter trial. Alcohol Clin Exp Res 23:230–235

    CAS  PubMed  Google Scholar 

  • Wiesbeck GA, Weijers HG, Lesch OM, Glaser T, Toennes PJ, Boening J (2001) Flupenthixol decanoate and relapse prevention in alcoholics: results from a placebo-controlled study. Alcohol Alcoholism 36:329–334

    Article  CAS  PubMed  Google Scholar 

  • Wise RA, Murray A, Bozarth MA (1990) Bromocriptine self-administration and bromocriptine-reinstatement of cocaine-trained and heroin-trained lever pressing in rats. Psychopharmacology 100:355–360

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank David Gorelick, M.D., for helpful comments on the manuscript.

Author information

Authors and Affiliations

  1. NIDA/IRP Treatment Section, Intramural Research Program, National Institute on Drug Abuse, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA

    David H. Epstein & Kenzie L. Preston

Authors
  1. David H. Epstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenzie L. Preston
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David H. Epstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Epstein, D.H., Preston, K.L. The reinstatement model and relapse prevention: a clinical perspective. Psychopharmacology 168, 31–41 (2003). https://doi.org/10.1007/s00213-003-1470-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-003-1470-6

Keywords

Search

Navigation