Experiments with cocaine and heroin addicts--are they predictive?

Treating cocaine addiction using dopamine replacement strategies, treats withdrawal but not relapse. Experiments with diverse pharmacological agents shows involvement of multiple pharmacologies and new approaches are emerging to treat the drug seeking behaviour and craving associated with relapse. Neuropathological studies are showing structural and connectivity changes in the brain of addicts which appear permanent, making control of learned behaviours associated with these changes extremely challenging. Heroin addiction is treated successfully with opiate replacement strategies but relapse and switch to other drugs of abuse remains. Combination therapies are partially successful in treating co-abused substances but do little to the heroin relapse rate. As with cocaine, attention is shifting to understanding the neuropathological changes, particularly in the pre-frontal cortex and hippocampus.