Effects of Initiating Abstinence from Alcohol on Daily Craving and Negative Affect: Results from a Pharmacotherapy Clinical Trial

Hallgren, Kevin A.; Delker, Brianna C.; Simpson, Tracy L.

doi:10.1111/acer.13591

Cited by 14 publications

(15 citation statements)

References 54 publications

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“…Therefore, from a clinical standpoint, it seems most important to prevent heavy drinking from occurring, but, if it does, to then intervene in order to keep periods of heavy drinking as brief as possible. One way clinicians might intervene is by educating clients about research-based data on the process of change in alcohol use patterns and that transition to remission predicts reductions in alcohol craving and negative affect following such transitions (Hallgren et al, 2016; Hallgren et al, 2017) as well as better longer-term drinking-related and psychosocial related outcomes several years after treatment (as found here). In other words, research-based data may bolster clinician efforts in helping clients reframe negative beliefs (e.g., I am a failure) after a relapse and in encouraging clients to work hard to “get back on their feet” once, or even several times, following one or more relapse episodes.…”

Section: Discussionmentioning

confidence: 56%

Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder

Maisto

Hallgren

Roos

et al. 2018

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 56%

Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder

Maisto

Hallgren

Roos

et al. 2018

Drug and Alcohol Dependence

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“…ment, such as establishing a period of abstinence prior to an attempt to moderate (Rotgers, Kern, & Hoeltzer, 2002), likely reduces craving overall, as demonstrated in a previous study (Hallgren et al, 2018), presumably allowing for greater coping across drinking contexts when there is a return to drinking. This return to drinking can then take into consideration HVCs, which may prompt an additional threat to return to high-risk drinking (Fatseas et al, 2015).…”

Section: Discussionmentioning

confidence: 76%

Context and craving among individuals with alcohol use disorder attempting to moderate their drinking.

Kuerbis¹,

Shao²,

Padovano³

et al. 2020

Experimental and Clinical Psychopharmacology

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Many individuals with alcohol use disorder (AUD) prefer a goal of moderation, because they do not see their drinking as causing severe enough consequences to merit abstinence. Given that individuals attempting to moderate will continue to put themselves in contexts where drinking occurs, understanding how distinct external alcohol cues prompt craving is important for implementing the optimal treatments for individuals with AUD. Using data from a randomized controlled trial of stepped care brief interventions for AUD, this study explored the relationship between drinking contexts and craving in individuals attempting to moderate their drinking using ecological momentary assessment (EMA). At baseline, participants were asked to prospectively identify drinking contexts that were particularly likely to elicit intense craving and heavy drinking, called highly valued drinking contexts (HVCs). During EMA, participants were asked to report three times a day (morning, afternoon, evening) on their non-mutually exclusive contexts and their level of craving. Using multilevel modeling, all drinking contexts were tested as concurrent predictors of craving across the 84 days of the study. Next, AUD severity was tested as a moderator of HVC on craving. Results demonstrated that being in an HVC corresponded to greater reports of any craving and intensity of craving, over and above the influences of several other contextual factors (e.g., negative affect and already drinking). AUD severity significantly moderated HVC's impact on any craving, such that greater AUD severity potentiated HVC's already high odds of any craving. Implications for treatments for individuals with AUD are discussed. Public Health SignificanceAlcohol use disorder (AUD) is a highly prevalent disorder, experienced around the globe. Craving, one of the hallmarks of AUD, is highly associated with continued use and/or relapse to use. This study provides important information about context eliciting craving that is useful to both those suffering with and treating AUD, so as to provide greater opportunities for reduction of harm and successful recovery.

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“…The relationships observed between COVID-19 disturbances, the severity of alcohol problems, and other indicators of psychological distress became non-significant when combined with craving in the multivariate model. In addition, the risk of alcohol drinking was lower in patients with a longer period of abstinence before inclusion in the univariate analysis, as craving and other negative effects tended to decline over time after patients initiated abstinence [ 40 ], but this relationship became marginally non-significant in the multivariate model. Taken together, these findings indicate that COVID-19 disturbances and psychological distress influenced the risk of alcohol drinking by increasing craving, a result that confirms that alcohol urge is the main predictor of relapse when patients with AUD have to deal with difficult situations.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Short-Term Alcohol Drinking in Patients with Alcohol Use Disorders during the Third Wave of the COVID-19 Pandemic: Prospective Study in Three Addiction Outpatient Centers in France

Constant

Sanz

Moirand

2022

IJERPH

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The present study investigates the extent to which the COVID-19 crisis disturbed different life domains of patients with alcohol use disorder (AUD) and assessed the associations between these disturbances and the risk of short-term alcohol drinking. All patients aged >18 years receiving outpatient care at three addiction treatment facilities from 15 April to 30 May 2021 were eligible for inclusion in the study. A trained resident assessed the extent to which the COVID-19 crisis affected their professional activity, social life, access to healthcare, and drinking problems, together with craving, drinking behavior, psychological distress, physical/mental health, and sociodemographic and clinical data. The same investigator assessed alcohol drinking 1 month after their visit. Nearly half of the patients felt that the COVID-19 crisis had a serious impact on their drinking problems, despite minor disruptions in access to healthcare. These disturbances significantly influenced short-term alcohol drinking in univariate analysis, together with psychological distress, craving, and drinking problems. Only craving predicted alcohol drinking in multivariate analyses, suggesting that psychological and drinking problems, as well as COVID-19 disturbances, increased the risk of alcohol drinking by increasing craving. Craving should be systematically investigated in patients with AUD to establish adapted social support systems during pandemics.

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Effects of Initiating Abstinence from Alcohol on Daily Craving and Negative Affect: Results from a Pharmacotherapy Clinical Trial

Cited by 14 publications

References 54 publications

Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder

Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder

Context and craving among individuals with alcohol use disorder attempting to moderate their drinking.

Predictors of Short-Term Alcohol Drinking in Patients with Alcohol Use Disorders during the Third Wave of the COVID-19 Pandemic: Prospective Study in Three Addiction Outpatient Centers in France

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