Nonpharmacological bases of drug tolerance and dependence

Research demonstrating a role of nonpharmacological factors in drug tolerance is reviewed. Other research documenting a role of similar nonpharmacological factors in post-treatment relapse is reviewed, and it is suggested that there may be a common mechanism involved in nonpharmacological influences on tolerance and relapse. Such a common mechanism, involving Pavlovian conditioned drug-compensatory responses, is described. Evidence is summarized implicating such conditioned responses in tolerance and post-treatment relapse. The treatment implications of the Pavlovian conditioning analysis are discussed.