Imagining the Future to Reshape the Past: A Path to Combine Cue Extinction and Memory Reconsolidation With Episodic Foresight for Addiction Treatment

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Continuous maladaptive drug-related memories that are resistant to extinction and cause drug-seeking behaviors to be triggered are known to be one of the hallmarks of drug addiction (1). These drug-related memories are salient, strong, and persistent due to chronic maladaptive consolidation processes. Due to the salient content of drug-related memories formed during drug-taking behaviors, certain stimuli (e.g., peers, locations, paraphernalia) become encoded with reward contingencies associated with drugs. As a result of this learning processing, drug-paired stimuli acquire incentive motivational properties that change them into salient cues (2). According to Pavlovian conditioning, consequent exposure to these stimuli (Henceforth called drug cues) activates the original memories and evokes craving. This enhanced retrieval co-occurs with the activation of limbic cortico-striatal pathways involved in reward processing (3). A serious question in addiction neuroscience is whether these memories could be actively erased/reshaped in favor of the recovery process. Different research groups suggested various treatment strategies during the last decade to modulate these memories. Here in this short opinion paper, we propose a novel framework titled “Cue-induced Retrieval and Reconsolidation with Episodic Foresight” (CIREF) that aims to combine three different cognitive interventions, i.e., cue-exposure, memory reconsolidation, and episodic future thinking, to reshape these maladaptive drug-related memories toward more adaptive memories to support addiction recovery.

addiction, cognitive training, cue-exposure therapy, episodic foresight, episodic future thinking, memory reconsolidation