Ecological momentary assessment of affect and craving in patients in treatment for prescription opioid dependence

Huhn, Andrew S.; Harris, Jonathan; Cleveland, H. Harrington; Lydon, David M.; Stankoski, Dean; Cleveland, Michael J.; Deneke, Erin; Bunce, Scott C.

doi:10.1016/j.brainresbull.2016.01.012

Cited by 41 publications

(34 citation statements)

References 55 publications

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“…Also, our results show that depression may be an important confounder of the relationship between pain and opioid craving for patients on opioid agonist therapy. Prior research suggests that negative affect may be associated with heroin and other drug craving among persons in treatment for opioid use disorders (Epstein et al, 2009; Huhn et al, 2016). Still, it is important to note that the association between any chronic pain and craving, although attenuated, remained strongly significant even after adjustment for depression suggesting independent effects.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the mechanisms whereby pain leads to craving or relapse are relatively unexplored. Prior research suggests that negative affect may be associated with heroin and other drug craving among persons in treatment for opioid use disorders (Epstein et al, 2009; Huhn et al, 2016), and in methadone maintenance treated samples, persons with chronic severe pain have been observed to have more symptoms of depression and anxiety (Barry et al, 2009a). …”

Section: Introductionmentioning

confidence: 99%

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Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Tsui

Lira

Cheng

et al. 2016

Drug and Alcohol Dependence

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Aims In a sample of patients receiving opioid agonist therapy, we evaluated whether having chronic pain was associated with a) craving for opioids and b) illicit opioid use. Methods In a cross-sectional study of adults on buprenorphine or methadone maintenance recruited from an urban medical center, we examined any craving for opioids (primary dependent variable) in the past week and recent illicit opioid use (secondary dependent variable). Illicit opioid use was defined as a positive urine drug test (UDT) for opiates and chronic pain was defined as bodily pain that had been present for at least 3 months. Multivariable logistic regression models were fit for each outcome, adjusting for age, sex, and non-white race. Additional models adjusted for depression (PHQ-9) and anxiety (STAI). Results The sample included 105 adults on methadone or buprenorphine maintenance. Mean age was 43.8 (SD±9.4) years; 48% were female and 32% non-white; 19% were on methadone. Chronic pain was present in 68% of the sample, 51% reported craving opioids in the past week, and 16% had a positive UDT. Chronic pain was associated with 3-fold higher odds of reporting craving in the past week (aOR=3.10; 95% CI: 1.28–7.50, p-value=0.01). The relative odds for having a positive UDT were not statistically significant (aOR=2.52; 95% CI: 0.64–9.90, p=0.18). Conclusion In this sample of patients treated with opioid agonist therapy, those with chronic pain had higher odds of reporting craving for opioids. Chronic pain with associated opioid craving potentially places this population at risk for relapse.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Tsui

Lira

Cheng

et al. 2016

Drug and Alcohol Dependence

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“…McFalls et al [in this issue] examine how such individual differences in avoidance of the heroin-paired saccharin cue are associated with individual differences in the expression of genes in the corticotrophin releasing hormone (CRH) signaling pathway in the prefrontal cortex, hippocampus, ventral tegmental area, and nucleus accumbens. Interestingly, these preclinical findings are paralleled by clinical work where Huhn et al [in this issue-b] use functional Near Infrared Imaging (fNIR) to track the behavioral and neural (prefrontal) response to natural rewards and ecological momentary assessment [Huhn, et al in this issue-a] to track affect and craving in recovering opioid addicted humans.…”

Section: Addiction and Devaluation Of Natural Rewardsmentioning

confidence: 99%

Addiction: A preclinical and clinical analysis

Grigson

2016

Brain Research Bulletin

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“…For example, EMA was instrumental in assessing the impact of cognitive, affective, and motivational factors (Huhn et al, 2016; Marhe, Waters, van de Wetering, & Franken, 2013; Waters, Marhe, & Franken, 2012) as well as stress (Preston et al, 2017) on drug craving and use among heroin- and/or cocaine-dependent patients. One study examined the feasibility and acceptability of EMA in a sample of four male and two female adult methamphetamine-dependent users (Galloway, Didier, Garrison, & Mendelson, 2008).…”

Section: Introductionmentioning

confidence: 99%

Ecological momentary assessments for self-monitoring and counseling to optimize methamphetamine treatment and sexual risk reduction outcomes among gay and bisexual men

Reback

Rünger

Fletcher

et al. 2018

Journal of Substance Abuse Treatment

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This pilot study evaluated the use of smartphone ecological momentary assessments (EMA) for self-monitoring to optimize treatment outcomes among gay and bisexual men enrolled in an outpatient methamphetamine abuse treatment service program. Participants (N = 34) received EMA prompts five times daily to self-monitor their methamphetamine use, cravings, sexual risk behaviors, and associated triggers and affect throughout the 8-week treatment program. Participants were randomized into either a self-directed condition with access to a web-based EMA response visualization dashboard (“EMA+Dashboard”; n = 16); or, a counselor-supported condition incorporating weekly, 30-minute, one-on-one counseling sessions to review and discuss the participant’s self-monitoring data on the dashboard (“EMA+Dashboard+Counselor”; n = 18). Pilot participants were compared with historical controls (n = 102) as the reference group in multiple regression analyses to assess the impact of the two study conditions on the treatment service program outcomes. Study participants with weekly counseling (EMA+Dashboard+Counselor) exhibited significantly greater reductions in the number of condomless anal intercourse episodes than historical controls (IRR = 0.02, 95% CI [0.00, 0.30]), whereas the reduction was of similar magnitude as controls in the EMA+Dashboard self-directed condition (IRR = 0.23, 95% CI [0.02, 3.56]). Treatment effects were not significant for comparisons between the two study conditions and historical controls for self-reported methamphetamine use (EMA+Dashboard: IRR = 1.06, 95% CI [0.32, 3.49]; EMA+Dashboard+Counselor: IRR = 0.46, 95% CI [0.14, 1.49]), number of male partners (EMA+Dashboard: IRR = 1.02, 95% CI [0.39, 2.61]; EMA+Dashboard+Counselor: IRR = 0.54, 95% CI [0.20, 1.45]), and the likelihood of providing a urine sample that tested positive for methamphetamine metabolites (EMA+Dashboard : OR = 1.00, 95% CI [0.79, 1.25]; EMA+Dashboard+Counselor: OR = 0.93, 95% CI [0.74, 1.16]). The pilot study provides preliminary evidence that the treatment outcome for condomless anal intercourse can be improved through a combination of smartphone- and counselor-assisted self-monitoring.

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Ecological momentary assessment of affect and craving in patients in treatment for prescription opioid dependence

Cited by 41 publications

References 55 publications

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Addiction: A preclinical and clinical analysis

Ecological momentary assessments for self-monitoring and counseling to optimize methamphetamine treatment and sexual risk reduction outcomes among gay and bisexual men

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