Predicting Relapse in Substance Use: Prospective Modeling Based on Intensive Longitudinal Data on Mental Health, Cognition, and Craving

Abstract

Patients with severe substance use disorders are often characterized by neurocognitive impairments and elevated mental health symptom load, typically associated with craving intensity and substance use relapse. There is a need to improve the predictive capabilities of when relapse occurs in order to improve substance use treatment. The current paper contains data from 19 patients (seven females) in a long-term inpatient substance use treatment setting over the course of several weeks, with up to three weekly data collections. We collected data from 252 sessions, ranging from 1 to 24 sessions per subject. The subjects reported craving, self-control, and mental health on each occasion. Before starting the repeated data collection, a baseline neuropsychological screening was performed. In this repeated-measures prospective study, the mixed-effects models with time-lagged predictors support a model of substance use craving and relapse being predicted by the baseline reaction time as well as the temporal changes and variability in mental health symptom load, self-control, and craving intensity with moderate to high effect sizes. This knowledge may contribute to more personalized risk assessments and treatments for this group of patients.

Speak and you shall predict: speech at initial cocaine abstinence as a biomarker of long-term drug use behavior

“…In identifying effective outcome predictors, it is therefore important to consider the potential distinctions in the trajectories of short and long-term recovery. Psychometric and behavioral measures including goal-directed thinking 20,21 , impulsivity 22 , and behavioral flexibility 23 have previously demonstrated predictive efficacy in individuals receiving treatment for SUD; compared to traditional clinical and demographic variables, these cognitive measures are better predictors of future drug use and treatment retention at both shorter (<six months) [24][25][26] and longer (≥six months) 27,28 intervals, supporting further investigation of such brain function measures.…”

Understanding Acquired Brain Injury: A Review

“…There are many mechanisms through which drugs and alcohol can have negative effects on the normal functioning of the brain. These include disturbing nutrient distribution to brain tissue, direct cellular damage, altered chemical homeostasis of the brain, and hypoxia [ 38 , 39 ].…”

A clinical trial of the Examen and mindfulness within a secular substance use disorder treatment program

“…The probability of relapse to SUDs is predicted by craving and mental distress, among other factors. Substance cravings are shown to predict relapse after residential addiction treatment (Lauvsnes et al, 2022;Stohs et al, 2019;Vafaie & Kober, 2022). Moreover, mental distress, such as depression, anxiety, and stress, often serves as an antecedent to addictive behavior (Amendola et al, 2022;Hunt et al, 2020;Pascoe et al, 2020).…”

“…Researchers have characterized substance use disorders (SUDs) as chronic and relapsing, with up to 30% of individuals relapsing within the first year of attempted sobriety and 40%–60% in general (Lauvsnes et al., 2022). The probability of relapse to SUDs is predicted by craving and mental distress, among other factors.…”