The team of academician Lu Lin of Peking University Sixth Hospital proposed a new strategy to prevent opioid relapse

Opioid Use Disorder (OUD) is a serious global health problem that not only causes disability and death, but also contributes to the widespread spread
of infectious diseases such as AIDS.
The current mainstay of treatment for OUD is methadone Maintenance Treatment (MMT), but MMT has limited efficacy, MMT maintenance rates remain unsatisfactory, and patients are still at high
risk of relapse.

After opioids enter the body, they can cause plasticity changes in the brain and form strong and lasting addictive memories, and existing studies believe that the persistence of pathological memories is the root cause
of psychological craving and relapse after long-term withdrawal in OUD patients.
Therefore, eliminating the patient's pathological addictive memory and reducing psychological desire is the key to the success of
treatment.

On September 28, 2022, the Lancet sub-journal eBioMedicine (IF = 11.
205) published an original paper by the team of Academician Lu Lin of Peking University Sixth Hospital online, entitled "The effect of a methadone-initiated memory reconsolidation updating procedure in opioid use disorder: A.
" This study proposes and validates a new method of preventing opioid relapse, the methadone-initiated memory reconsolidation updating procedure (MMRUP) based on methadone, and realizes the transformation
of results from animal research to clinical trials.
Yue Jingli, assistant researcher of Peking University Sixth Hospital, and Yuan Kai, associate researcher, are the co-first authors of the paper, and Academician Lu Lin, president of Peking University Sixth Hospital, Professor Thomas Kosten, professor of Baylor College of Medicine, and Wu Ping and Xue Yanxue, associate researchers of the China Institute of Drug Dependence of Peking University, are the co-corresponding authors
.

This paper found that in animal models of heroin addiction, MMRUP, i.
e.
memory renewal within the methadone-induced reconsolidation time window, significantly reduced the re-initiation of drug seeking behavior in rats after long-term
withdrawal compared with simple methadone administration + memory extinction intervention.
Studies in patients with OUD have found that compared with conventional MMT therapy, methadone for 10 minutes with MMRUP significantly promotes sustained abstinence and treatment retention during the 6-month study period, and reduces mental and physiological changes
such as lead-induced heroin craving and blood pressure.
This research is an important result
of the in-depth exploration of Academician Lu Lin's team on the basis of previous research.
Academician Lu Lin's team published papers in Science, Nature Communications and JAMA Psychiatry in 2012, 2015 and 2017 respectively, and successively proposed conditional cue memory arousal and non-conditioned cue memory arousal intervention paradigms, and found that the memory manipulation paradigm can eliminate the addictive memories of addicted animals and addicts, and reduce their psychological craving and relapse risk
of addictive substances.
These research results provide new ideas and directions
for the prevention and treatment of substance addiction relapse.

MMRUP significantly improves several important outcomes of MMT treatment in people with OUD

This research work was supported
by the National Natural Science Foundation of China and the Science and Technology Innovation 2030-Brain Science and Brain-like Research Program.