Tobacco, cocaine, and heroin: Craving and use during daily life

Abstract

Background-Relationships among tobacco smoking, tobacco craving, and other drug use and craving may have treatment implications in polydrug-dependent individuals.Methods-We conducted the first ecological momentary assessment (EMA) study to investigate how smoking is related to other drug use and craving during daily life. For up to 20 weeks, 106 methadone-maintained outpatients carried PalmPilots (PDAs). They reported their craving, mood, behaviors, environment, and cigarette-smoking status in 2 to 5 random-prompt entries per day and initiated PDA entries when they used cocaine or heroin or had a discrete episode of craving for cocaine or heroin.Results-Smoking frequency increased linearly with random-prompt ratings of tobacco craving, cocaine craving, and craving for both cocaine and heroin. Smoking frequency was greater during discrete episodes of cocaine use and craving than during random-prompt reports of low craving for cocaine. This pattern was also significant for dual cocaine and heroin use and craving. Smoking and tobacco craving were each considerably reduced during periods of urine-verified abstinence from cocaine, and there was a (nonsignificant) tendency for morning smoking to be especially reduced during those periods.Conclusions-This EMA study confirms that smoking and tobacco craving are strongly associated with the use of and craving for cocaine and heroin. Together with prior findings, our data suggest that tobacco and cocaine may each increase craving for (and likelihood of continued use of) themselves and each other. Treatment for tobacco dependence should probably be offered concurrently with (rather than only after) initiation of treatment for other substance-use disorders.

Brain Activity During Cocaine Craving and Gambling Urges: An fMRI Study

“…As reviewed previously, craving is a key feature of both SUDs (O'Brien et al, 1998;Volkow et al, 2006) and PG (Potenza et al, 2003b) that predicts drug use, gambling, and relapse to those behaviors (eg, Epstein et al, 2010). Consistently, commonly practiced and effective treatments for these disorders include components on identifying triggers for craving and on regulation of craving (such as relapse prevention and cognitive-behavioral therapy; Carroll, 2008;Grant et al, 2009).…”

“…Appetitive and motivational states like drug cravings are central to SUDs, including CD (O'Brien et al, 1998;Volkow et al, 2006) and are associated with drug-taking and relapse (eg, Epstein et al, 2010). Similarly, gambling urges contribute importantly to PG, correlating with problem-gambling severity (Petry et al, 2005) and relapse to gambling (Oei and Gordon, 2008).…”

Le craving comme symptôme central de la toxicomanie : de ses fondements neurobiologiques à sa pertinence clinique

“…Un bon nombre d'études suggèrent que la consommation d'alcool, de cocaïne, d'héroïne et de tabac chez les individus dépendants est souvent précédée de craving (Epstein, Marrone, Heishman, Schmittner et Preston, 2010 ;Paliwal, Hyman et Sinha, 2008). De plus, la plupart des études démontrent que plus le niveau de craving est important chez les individus dépendants et abstinents, plus le risque de rechute et le retour à la consommation sont probables, autant lors d'une cure de désintoxication en milieu hospitalier que lors d'un suivi en externe (Sinha, 2011).…”

Cigarette Smoking and Quit Attempts Among Injection Drug Users in Tijuana, Mexico

“…Previous studies have found an extremely high cigarette smoking prevalence (90% or higher) among IDUs and a positive correlation between patterns of cigarette smoking and drug use (Clarke, Stein, McGarry, & Gogineni, 2001;Epstein, Marrone, Heishman, Schmittner, & Preston, 2010;Marshall et al, 2011;Villanti, German, Sifakis, Flynn, & Holtgrave, 2012). Craving for nicotine might increase craving for drugs, particularly for cocaine (Epstein et al, 2010;Harrell, Montoya, Preston, Juliano, & Gorelick, 2011;Levine et al, 2011).…”

“…Craving for nicotine might increase craving for drugs, particularly for cocaine (Epstein et al, 2010;Harrell, Montoya, Preston, Juliano, & Gorelick, 2011;Levine et al, 2011).…”