Nipping Cue Reactivity in the Bud: Baclofen Prevents Limbic Activation Elicited by Subliminal Drug Cues

The research presented here demonstrates a truly novel approach to the treatment of cocaine addiction. More recent literature indicates activation associated with the limbic system in response to drug cues (Childress et al., 2015). Comprehensive literature searches indicate that, to date, there has not been any significant advancement in this regard. Treatment via drugs such as Baclofen remains an area of untapped potential.

While there is no doubt that the prevention of subliminal drug cues will play an instrumental role in the prevention of relapse in the future, would not the actual onset of these cues be virtually unknown to the individual him/herself? There continues to be a glaring paucity of research in this area. While conscious drug cues themselves are considered subjective in nature, cues of a subconscious nature will consequently be of a more controversial nature when treatment options are being considered. Among the findings mentioned in the paper, the authors conceded the possibility of Baclofen exerting more generalized effects on motivational processes, considering its role as a dopamine modulator. As a result, its role in pharmacotherapy becomes immediately questionable - would the advantages of using such a drug to treat essentially undetectable subliminal cues override the risk associated with generalized effects on motivational responses that extend to other facets of life? The practicality of using this drug so comes into question - how would clinicians be aware of the presence of subliminal drug cues so as to justify the use of Baclofen for treatment? The obvious answer is to use neuroimaging measures, such as fMRI. But would this be effective in the treatment of addiction when large populations are considered? Considering the number of addicted individuals in the present day, subjecting individuals who have been treated for cocaine addiction to fMRI tests at regular intervals seems like a sensible strategy, but definitely not cost-effective in the long-term.

The question I posit here by no means seeks to undermine the novel findings presented by the authors. As I mentioned earlier, the findings demonstrate a significant area of untapped potential when it comes to the treatment of cocaine addiction (and potentially addiction to other drugs). Indeed, there have been findings for Baclofen's usefulness in the treatment of alcohol dependence and comorbid anxiety (Morley et al., 2014), although, in this instance, the findings were quite selective to the specific condition of alcohol dependence and comorbid anxiety. This therefore highlights the need for more research with this specific focus.

Conflict of Interest:

None declared