Substance-related cravings and relapses: clinical implications.

OBJECTIVE

To review the implications of current research on clinical practice.

METHOD

An examination of the literature over the last 10 years and the data from our own study group.

RESULTS

A synopsis of current psychobiological and psychological conceptual underpinnings of the nature and process of cravings and relapses among substance-dependent individuals is presented. The biopsychosocial dimensions of the clinical assessment of craving components, relapse patterns, and predictors, including relevant instruments, are explored. The panoply of management strategies for cravings and relapses encompasses cue exposure treatment techniques, relapse prevention approaches, anticraving and psychotropic medication, family involvement, and twelve-step programs.

CONCLUSION

A clinician's familiarity with these strategies should contribute significantly to the transformation of the sense of failure engendered by a patient's relapse into a constructive challenge and opportunity.