This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.



The central problem in the treatment of cocaine and heroin addiction is high rates of relapse to drug use after periods of forced or self-imposed abstinence. Relapse can be modeled in laboratory animals a reinstatement procedure in which responding for drug is extinguished and then reinstated by acute exposure to the drug, drug cues, or stress. In this review, we first summarize data from recent (2003–2005) studies on the neural substrates involved in reinstatement of heroin and cocaine seeking. We also discuss the neural mechanisms underlying the progressive increase in cocaine seeking after withdrawal (incubation of cocaine craving). Finally, we provide an update on several novel candidate medications for relapse prevention suggested by recent preclinical studies, and we discuss the translation of findings from nonhuman laboratory studies to the clinical phenomenon of relapse.¹

Drug Table: Hunts Point, Bronx. Courtesy of Chris Arnade.

Out of detox

Weighed down

By bags of clothes and a sensation

To run:

He cannot be seen. But she needs

Diesel, two bags.

He is clean,

Clean suburban husband

Wannabe left seat-tapping in

A mini-van. He has conquered and

This is her fault, her and her

Medusa'ed habit:

"Shit, I saw a white

Van and almost zombie-walked

Into a bust. Fuck, it's raining

So Jose ain't at his corner

Because he's a pussy,"

She said,

Who then, for Buddha Bless?

She wanders.

He waits clean, proper until

Mania -- there, on the sidewalk,

The dealer.

"Goddammit she's walking

The wrong way.

God fucking dammit."

His rage is a thumping thing

Against the seat

Matching her return

Crescendo of fury


"I bumped into

My dope fairy." Bought

Four bags instead

Of two.


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