The contexts where drugs are self-administered play an important role in regulating persistent drug taking and in relapse to such taking after periods of abstinence. Here, we review the behavioral and brain mechanisms enabling contexts to promote and prevent relapse to drug seeking. We review the key brain structures, their neuropharmacology and their connectivity. We discuss the similarities and differences between the mechanisms for context-induced reinstatement of drug seeking vs. other forms of relapse to drug seeking in animal models and we highlight the numerous deficits in our understanding. We emphasize that current understanding, although significant, defies explanations in terms of models at the level of brain structures and their connectivity. Rather, we show that there is significant functional compartmentalization and segregation within these structures during reinstatement and extinction of drug seeking that parallels their anatomical segregation into circuits and channels. A key challenge is to recognize this complexity, understand how these circuits and channels are organized, as well as understand how different modes of activity of ensembles of neurons within them promote abstinence or relapse to drug seeking.Keywords: Accumbens, addiction, amygdala, circuits, context-induced reinstatement, learning, orexin, prefrontal cortex, reinstatement, relapse, renewal
Received 15 June 2016, revised 13 August 2016 and 30 August 2016, accepted for publication 31 August 2016Drug addiction remains a chronic condition imposing significant burdens on individuals, their families and communities. It is associated with increased rates of physical health problems including cardiovascular and liver disease; mental health problems including depression and anxiety; reduced levels of productivity, as well as higher utilization of health and social services (Lim et al. 2012;Nutt et al. 2010;Rehm et al. 2009). Considerable progress has been made in understanding the mechanisms of drug addiction including those contributing to the reinforcing effects of drugs of abuse and the escalation as well as loss of control over drug intake rendering it compulsive. A fundamental problem is relapse to drug taking after a period of abstinence. Rates of relapse are high and largely unchanged over a long period of time ( Basic work in neuroscience has provided significant information on the behavioral and brain mechanisms that initiate and sustain behavioral change. The relevance and importance of this work to the clinical problem of relapse is rightly judged on its clinical impact (Connor et al. 2016;Hall et al. 2014). There have been some successes, but much of this basic work is yet to achieve translational success (Heilig et al. 2016). There are many reasons for this but one theme that we explore here is that the mechanisms for behavioral change during extinction and reinstatement are significantly more nuanced than most current models of relapse to drug seeking allow. Here, we review current knowledge on how contexts promote and pr...