Addiction and emotion: Theories, assessment techniques, and treatment implications.

Epstein, David H.; Willner-Reid, Jessica; Preston, Kenzie L.

doi:10.1037/12067-011

Cited by 2 publications

(1 citation statement)

References 73 publications

(94 reference statements)

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“…The latter finding seems likely to have been secondary to reductions in use; thus, taken together, our prior and current findings are consistent with a bidirectional effect of cocaine craving and cocaine use on each other. The causes of cocaine use probably vary not only across individuals, but within each individual, so that there may be no single correct answer to the question of whether craving causes use (Epstein et al in press). However, we think our findings support continued efforts to develop a treatment that suppresses cocaine craving.…”

Section: Discussionmentioning

confidence: 99%

Cocaine craving and use during daily life

et al. 2009

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Rationale-Craving is often assumed to cause ongoing drug use and relapse and is a major focus of addiction research. However, its relationship to drug use has not been adequately documented.Objectives-The aim of this study was to investigate the relationship between craving and drug use in real time and in the daily living environments of drug users. Methods-In a prospective, longitudinal, cohort design (Ecological Momentary Assessment), 112cocaine-abusing individuals in methadone maintenance treatment rated their craving and mood at random times (two to five times daily, prompted by electronic diaries) as they went about their everyday activities. They also initiated an electronic-diary entry each time they used cocaine. Drug use was monitored by thrice-weekly urine testing.Results-During periods of urine-verified cocaine use, ratings of cocaine craving increased across the day and were higher than during periods of urine-verified abstinence. During the five hours prior to cocaine use, ratings of craving significantly increased. These patterns were not seen in ratings of heroin craving or mood (e.g., feeling happy or bored).Conclusions-Cocaine craving is tightly coupled to cocaine use in users' normal environments. Our findings provide previously unavailable support for a relationship that has been seriously questioned in some theoretical accounts. We discuss what steps will be needed to determine whether craving causes use. Keywordscraving; Ecological Momentary Assessment; cocaine; mood; addiction; psychological theory Craving-a conscious, reportable urge-is a frequently discussed aspect of drug addiction (Lowman et al. 2000;Pickens and Johanson 1992), but its exact role in addiction, particularly its relationship with drug use and relapse, has been disputed from both theoretical and clinical perspectives. Across the spectrum of addiction theories, craving is given varying degrees of importance as a driver of drug use (Drummond 2001). NIH Public AccessAuthor Manuscript Psychopharmacology (Berl). Author manuscript; available in PMC 2010 September 20. Published in final edited form as:Psychopharmacology (Berl Clinical studies of the relationship between craving and drug use have had mixed results. Some studies have shown that craving before or during treatment predicts post-treatment cocaine use (Baer et al. 1989;Hartz et al. 2001;Paliwal et al. 2008;Rohsenow et al. 2007;Weiss et al. 2003), while others have shown no relationship (Kranzler et al. 1999;Walton et al. 2003;Weiss et al. 1995). In laboratory studies, the amount of cocaine craving induced by stressors in experimental sessions predicts time to resumption of cocaine use in daily life ; similar findings have been reported for tobacco smokers, with either stress-induced (al'Absi et al. 2005) or cue-induced craving . However, during an experimental session, reductions in craving do not necessarily lead to reductions in drug selfadministration (Haney and Spealman 2008;Leyton et al. 2005;Sofuoglu et al. 2009).In spite of the mixed clinical data, muc...

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Section: Discussionmentioning

confidence: 99%