Anesthesia is a risk factor for drug and alcohol craving and relapse in ex-abusers.

Relapse to cocaine, heroin, and alcohol is a common occurrence in ex-abusers of these substances. Although there are many potential causes for relapse, we postulate that one cause in some people may be re-exposure in an anesthesia setting to a drug similar to the formerly abused drug. We hypothesize, for example, that opioids given during and after surgery may reinstate craving for, and initiate subsequent seeking of, heroin in former abusers. There are a substantial number of animal studies and some human studies documenting a reinstatement phenomenon in which an experimenter-administered psychoactive drug can precipitate drug-seeking behavior in 'abstinent' animals and humans. There is concern amongst health professionals and patients alike on this issue, and we discuss possible avenues of research, both preclinical and clinical, to explore the validity of our hypothesis.