New findings on biological factors predicting addiction relapse vulnerability

Sinha, Rajita

doi:10.1007/s11920-011-0224-0

Cited by 401Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorOpioid Use Disorder Treatment

New findings on biological factors predicting addiction relapse vulnerability

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Sinha, Rajita·2011·Current Psychiatry Reports

DOI 10.1007/s11920-011-0224-0PMC PMC3674771

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Abstract

Relapse is a highly prevalent phenomenon in addiction. This paper examines the new research on identifying biological factors that contribute to addiction relapse risk. Prospective studies examining relapse risk are reviewed, and clinical, biological, and neural factors that predict relapse risk are identified. Clinical factors, patient-related factors, and subjective and behavioral measures such as depressive symptoms, stress, and drug craving all predict future relapse risk. Among biological measures, endocrine measures such as cortisol and cortisol/corticotropin (ACTH) ratio as a measure of adrenal sensitivity and serum brain-derived neurotrophic factor were also predictive of future relapse risk. Among neural measures, brain atrophy in the medial frontal regions and hyperreactivity of the anterior cingulate during withdrawal were identified as important in drug withdrawal and relapse risk. Caveats pertaining to specific drug abuse type and phase of addiction are discussed. Finally, significant implications of these findings for clinical practice are presented, with a specific focus on determining biological markers of relapse risk that may be used to identify those individuals who are most at risk of relapse in the clinic. Such markers may then be used to assess treatment response and develop specific treatments that will normalize these neural and biological sequelae so as to significantly improve relapse outcomes.

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Alcohol addiction has high relapse rates, with around 80% of relapse within a year of discharge.
“Alcohol addiction has high relapse rates, with around 80% of relapse within a year of discharge, 10 with cravings playing a crucial role, making them a valuable target for influencing behaviors.11-13”
From Enhancing Emotion Regulation and Overcoming Craving in Alcohol Dependence Syndrome Through Mindfulness-based Relapse Prevention (2025) · cites this paper as [10]
The Addiction Relapse Vulnerability section reports that more than 85% relapse within one year of treatment, but that figure covers alcohol and several other addictions, not alcohol alone. Its alcohol-related abstinence figure was measured at discharge, not one year afterward. The paper supports a high relapse rate but not the claim’s specific population, percentage, and timing. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Relapse rates for substance use disorders are high.
“relapse rates are high.12”
From Safety and psychological impact of sailing adventure therapy among Veterans with substance use disorders (2018) · cites this paper as [12]
Relapse to alcohol abuse is a critical clinical issue.
“Most alcoholic patients will relapse within the first year of abstinence3, highlighting relapse as a critical clinical issue.”
From Disruption of alcohol-related memories by mTORC1 inhibition prevents relapse (2013) · cites this paper as [3]

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Authors: Sinha, R.
Affiliations: Yale University (US)
Corresponding author: Sinha, Rajita
ORCID: Sinha, Rajita
Venue: Current Psychiatry Reports
Publisher: Springer Science and Business Media LLC
Published: 2011-07-27
Volume: 13
Issue: 5
Pages: 398-405
ISSN: 1523-3812 (ISSN-L)
1535-1645
DOI: 10.1007/s11920-011-0224-0
PMC: PMC3674771
OpenAlex: W2136772960
Cited by: 401
References: 100
Citations by year: 2026: 29 · 2025: 38 · 2024: 41 · 2023: 49 · 2022: 38 · 2021: 40 · 2020: 39 · 2019: 33 · 2018: 24 · 2017: 11 · 2016: 10 · 2015: 15 · 2014: 15 · 2013: 13 · 2012: 6
FWCI: 1.28
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Current Psychiatry Reports (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (R01AA013892, R01-AA-13892)
National Institute on Drug Abuse (P50-DA165556, R01-DA27230, PL1DA024859)
National Institute of Dental and Craniofacial Research (UL1-DE019589)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: addiction relapse, relapse risk prediction, biomarkers, drug craving, depressive symptoms, stress, cortisol, ACTH, brain-derived neurotrophic factor, brain atrophy, drug withdrawal, neural factors, hormonal factors
MeSH terms: Adrenocorticotropic Hormone, Humans, Hydrocortisone, Predictive Value of Tests, Prospective Studies, Recurrence, Biomarkers, Brain-Derived Neurotrophic Factor, Substance-Related Disorders, Neuroimaging

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New findings on biological factors predicting addiction relapse vulnerability

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