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