Kindling of Withdrawal: A Study of Craving and Anxiety After Multiple Detoxifications in Alcoholic Inpatients

Abstract

These data suggest that for inpatients with short history of alcoholism, the consequences of multiple withdrawals may not relate to anxiety or craving.

Previous experience of ethanol withdrawal increases withdrawal-induced c-fos expression in limbic areas, but not withdrawal-induced anxiety and prevents withdrawal-induced elevations in plasma corticosterone

“…This conclusion also fits with our clinical observations that withdrawal-associated anxiety is not increased following multiple withdrawals (Duka et al 2002).…”

“…Nevertheless, there is mixed evidence in the literature that the number of previous detoxification experiences influences anxiety levels in alcoholics undergoing acute detoxification. In one study, several days into detoxification of alcoholic inpatients, although we found increased levels of anxiety in patients undergoing detoxification, anxiety levels were not exacerbated by prior withdrawal experience (Duka et al 2002). In contrast, (Malcolm et al 2002) found some evidence for a mild increase in anxiety in this population very early in withdrawal.…”

The priming effect of alcohol pre-load on attentional bias to alcohol-related stimuli

“…The alcohol Stroop effect has been previously demonstrated with alcohol dependent individuals (Stetter et al 1995;Bauer and Cox 1998;Duka et al 2002). In social drinkers, Cox and colleagues (Cox et al 1999) found that heavy drinkers are slower to name the ink colour of alcohol-related words than that of neutral control words and more recently, Sharma and colleagues (Sharma et al 2001) found an attentional bias using alcohol Stroop in both problem and non-problem social drinkers.…”

“…name the colour in which the word is printed) and subjects require more time to perform and/or produce more errors than in the case when the word meaning has no emotional salience. It has previously been used to demonstrate interference in individuals who suffer from anxiety or other emotional disorders as well as from alcohol addiction (Stetter et al 1995;Duka et al 2002). Alcohol pre-load was previously shown to increase alcohol-related semantic mental representations (Glautier and Spencer 1999); such an effect could also increase interference in a Stroop task.…”

Lifetime physical and sexual abuse and substance use treatment outcomes in men

“…Although differences in the number of prior SUD treatment episodes may be an important indicator of future relapse (Duka, Townshend, Collier, & Stephens, 2002;Malcolm, Herron, Anton, Roberts, & Moore, 2000), little research has examined the association between abuse history and the number of SUD treatment episodes. In the only study we found to address this issue, no differences in the number of prior SUD treatment episodes emerged between SUD patients with and without a history of physical or sexual abuse (Pirard et al, 2005).…”