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Craving
Kinds of Craving Terms modified by Craving Selected AbstractsWHAT'S THE MATTER WITH CUE-INDUCED CRAVING?ADDICTION, Issue 10 2010A COMMENTARY ON PERKINS No abstract is available for this article. [source] IMPLICATIONS OF THE MULTIPLE-VULNERABILITIES THEORY OF ADDICTION FOR CRAVING AND RELAPSEADDICTION, Issue 11 2009A. DAVID REDISH No abstract is available for this article. [source] THE CONTINUING CONUNDRUM OF CRAVINGADDICTION, Issue 10 2009STEPHEN T. TIFFANY No abstract is available for this article. [source] Withdrawal symptoms in abstinent methamphetamine-dependent subjectsADDICTION, Issue 10 2010Todd Zorick ABSTRACT Aims Withdrawal symptoms have been linked to a propensity for relapse to drug abuse. Inasmuch as this association applies to methamphetamine (MA) abuse, an understanding of the course of MA withdrawal symptoms may help to direct treatment for MA dependence. Previous studies of symptoms manifested during abstinence from MA have been limited in size and scope. We asked (i) whether debilitating psychological and/or physical symptoms appear during the first several weeks of MA abstinence, (ii) how craving for MA evolves and (iii) whether psychiatric symptoms (e.g. depression, psychosis) persist beyond a month of abstinence. Design A study of MA-dependent participants, who initiated and maintained abstinence from the drug for up to 5 weeks, compared to a matched healthy comparison group. Setting In-patient research hospital ward (MA-dependent subjects) and out-patient (comparison subjects). Participants Fifty-six MA-dependent and eighty-nine comparison subjects. Measurements Rater-assessed MA withdrawal questionnaire and self-report assessment of craving (MA-dependent subjects) and self-report assessment of psychiatric symptoms (both groups). Findings At study entry, MA-dependent subjects exhibited a wide range in severity of depressive symptoms, with the average score at a mild,moderate level of severity. Symptoms of psychosis were also prevalent. While depressive and psychotic symptoms largely resolved within a week of abstinence, craving did not decrease significantly from the time of initiating abstinence until the second week, and then continued at a reduced level to the fifth week. Conclusions Depressive and psychotic symptoms accompany acute withdrawal from methamphetamine but resolve within 1 week. Craving is also present and lasts at least 5 weeks. [source] Behavioral economic analysis of cue-elicited craving for alcoholADDICTION, Issue 9 2010James MacKillop ABSTRACT Aims Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. Design One-way within-subjects design. Setting Human laboratory environment. Participants Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. Assessments Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. Findings Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (Omax), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized Pmax). Craving was significantly correlated with demand measures at levels ranging from 0.21,0.43. Conclusions These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving. [source] The impact of cigarette deprivation and cigarette availability on cue,reactivity in smokersADDICTION, Issue 2 2010Steffani R. Bailey ABSTRACT Aims This experiment was conducted to determine the impact of cigarette deprivation and cigarette availability on reactivity measures to cigarette cues. Participants Smokers were recruited who were 18 years of age or older, not attempting to quit or cut down on their smoking, smoked at least 20 cigarettes daily, had been smoking regularly for past year and had an expired carbon monoxide level of at least 10 parts per million. Design Smokers were assigned randomly to abstain from smoking for 24 hours (n = 51) or continue smoking their regular amount (n = 50). Twenty-four hours later, they were exposed to trials of either a lit cigarette or a glass of water with a 0, 50 or 100% probability of being able to sample the cue on each trial. Craving, mood, heart rate, skin conductance, puff topography and latency to access door to sample the cue were measured. Findings Both exposure to cigarette cues and increasing availability of those cues produced higher levels of craving to smoke. Deprivation produced a generalized increase in craving. There was no consistent evidence, however, that even under conditions of high cigarette availability, deprived smokers were sensitized selectively to presentations of cigarette cues. Conclusions The data suggest that, even under conditions of immediate cigarette availability, deprivation and cue presentations have independent, additive effects on self-reported craving levels in smokers. [source] Influence of smoking cues in movies on craving among smokersADDICTION, Issue 12 2009Kirsten Lochbuehler ABSTRACT Aims Research has shown that smoking-related cues are important triggers for craving. The objective of the present study was to test whether smoking cues in movies also function as triggers to evoke craving. To accomplish this, we conducted a pilot study in which we examined smokers' reactivity to smoking cues from a particular movie in a common cue,reactivity paradigm using pictures. In the main study, we tested whether smokers who are confronted with smoking characters in a movie segment have a greater desire to smoke than smokers confronted with non-smoking characters. Design Using an experimental design, participants were assigned randomly to one of two movie conditions (smoking versus non-smoking characters). Setting In a laboratory, that reflected a naturalistic setting, participants watched a 41-minute movie segment. Participants A total of 65 young adults who smoked on a daily basis participated in the experiment. Measurements Craving was assessed before and after watching the movie. Findings The pilot study revealed that pictures of smoking characters had strong effects on craving. However, when smokers actually watched a movie segment, no differences in craving were found between those who watched smoking characters and those who watched non-smoking characters. This finding was not affected by baseline craving, the time of the last cigarette smoked and daily smoking habits. Conclusions No effect of smoking cues in movies on craving was found, in contrast with research supporting the cue-craving link. Thus, if replicated, this might indicate that smoking cues in such contexts do not affect smokers' desire to smoke as expected. [source] Comparison of three models of alcohol craving in young adults: a cross-validationADDICTION, Issue 4 2004Peter M. McEvoy ABSTRACT Aims The aim of study 1 was to develop a three-factor Approach and Avoidance of Alcohol Questionnaire (AAAQ), designed to assess mild and intense inclinations to drink, as well as inclinations to avoid drinking. The aims of study 2 were to cross-validate the AAAQ with an independent sample and to test the goodness-of-fit of three models of craving for alcohol: (a) the traditional unidimensional model; (b) a two-dimensional, approach,avoidance ambivalence model; and (c) an expanded two-dimensional neuroanatomical model that retains avoidance, while positing a threshold that partitions approach into two distinct levels and relates all three factors involved in craving to brain pathways associated with inhibitory processes, reward and obsessive,compulsive behaviour, respectively. Design, setting and participants The survey was administered to 589 Australian university students (69% women) in study 1 and to 523 American university students (64% women) in study 2. Measurements Inclinations to drink and to not drink (AAAQ), drinking behaviour (quantity and frequency), drinking problems (Young Adult Alcohol Problems Screening Test; YAAPST) and readiness for change (Stages of Change Readiness and Treatment Eagerness Scale; SOCRATES). Findings The expanded two-dimensional neuroanatomical model provided the best fit to the data. The AAAQ explained a substantial proportion of the variance in drinking frequency (41,53%), drinking quantity (49,60%) and drinking problems (43%). AAAQ profiles differed as a function of drinking-related risk, and the three AAAQ scales differentially predicted readiness for change. Conclusions Approach and avoidance inclinations toward alcohol are separable constructs, and their activation may not be invariably reciprocal. Craving can be defined as the relative activation of substance-related response inclinations along these two primary dimensions. There may be a threshold of intensity that separates mild from intense approach inclinations. [source] Craving: what can be done to bring the insights of neuroscience, behavioral science and clinical science into synchronyADDICTION, Issue 8s2 2000Roger E. Meyer Alcohol self-administration behavior is the common thread that is necessary to bring the insights of neuroscience, behavioral science and clinical science into synchrony around the concept of craving. Animal models should address the molecular and cellular changes that take place in behaviorally relevant brain regions of rats consequent to chronic self-administration of ethanol. Animal models can focus on the biology of the anticipatory state in alcohol preferring/consuming rats, as well as studies of the effects of possible medications on this state in the animal model, on actual alcohol consuming behavior, and on the residual effects of chronic alcohol on the non-human mammalian brain. In human studies of craving, cue-reactivity in the absence of the opportunity to drink alcohol does not have the same salience as cue-reactivity in which drinking is possible. Moreover, actual drinking behavior serves to validate self-reports of craving. Studies of limited alcohol self-administration in the laboratory are an essential element in screening new medications for the treatment of alcoholism. Studies to date suggest no adverse reaction to the participation of alcoholic subjects in limited alcohol self-administration studies, but the research community should continue to monitor carefully the outcomes of alcohol-dependent subjects who participate in this type of research, and efforts should always be made to encourage these subjects to enter active treatment. In outpatient clinical trials of new treatments for alcoholism, the assessment of craving should include queries regarding symptoms and signs of protracted abstinence such as sleep disturbances, as well as questions regarding situational craving. Field observations of alcoholics in their favorite drinking environments would contribute greatly to our understanding of the real-world phenomenology of craving. [source] Blood Glucose Level, Alcohol Heavy Drinking, and Alcohol Craving During Treatment for Alcohol Dependence: Results From the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) StudyALCOHOLISM, Issue 9 2009Lorenzo Leggio Background:, Heavy drinking may increase blood glucose levels. Moreover, in alcohol-dependent subjects, glucose may play a putative role in alcohol preference. Methods:, This study investigated the relationship between blood glucose levels and both alcohol heavy drinking and craving in alcohol-dependent subjects participating in the COMBINE Study. The primary objective was to evaluate the relationship between baseline (pretreatment) glucose levels and percentage of heavy drinking day (PHDD) during treatment. The secondary objective was to evaluate the relationship between glucose levels, baseline PHDD, and craving measured by the Obsessive Compulsive Drinking Scale (OCDS). Results:, This analysis consisted of 1,324 participants. Baseline glucose levels were significantly and positively associated with PHDD during treatment [F(1, 1225) = 5.21, p = 0.023], after controlling for baseline PHDD [F(1, 1225) = 36.25, p < 0.0001], gender [F (1, 1225) = 3.33, p = 0.07], and body mass index (BMI) [F(1, 1225) = 0.31, p = 0.58]. Higher glucose levels at baseline were associated with a higher percentage of PHDD at pretreatment [F(1, 1304) = 5.96, p = 0.015], after controlling for gender [F(1, 1304) = 0.29, p = 0.59] and BMI [F(1, 1304) = 0.90, p = 0.34]. Glucose was not significantly associated with the OCDS total score [F(1, 1304) = 0.12, p = 0.73], the OCDS Obsessive subscale [F(1, 1304) = 0.35, p = 0.56], or the OCDS Compulsive subscale [F(1, 1304) = 1.19, p = 0.28] scores, after controlling for gender and BMI. Discussion:, A link between pretreatment glucose levels and heavy drinking during treatment was found, suggesting a role of glucose in predicting heavy alcohol consumption. Although caution is needed in the interpretation of these results, elevated glucose and heavy drinking may be affected by a common mechanism and manipulations affecting glucose regulation may influence alcohol consumption. [source] Can Serotonin Transporter Genotype Predict Craving in Alcoholism?ALCOHOLISM, Issue 8 2009Nassima Ait-Daoud Background:, We hypothesize that functional control of the serotonergic system is regulated in part by differential expression of the serotonin (5-HT) transporter (5-HTT). Alcohol-dependent individuals with the LL/LS genotype (L-carriers), compared with those with the SS genotype, have a lower 5-HT neurotransmission, which we hypothesize would be associated with higher craving for alcohol among L-carriers. We hypothesize further that acute peripheral depletion of tryptophan (5-HT's precursor), while further reducing 5-HT function, might decrease auto-inhibition of 5-HT neuronal firing, thereby increasing 5-HT neurotransmission transiently and lowering alcohol craving. Methods:, We tested these hypotheses by examining whether in 34 Hispanic alcohol-dependent individuals subjective and physiological cue craving for alcohol differed by genotype, age of onset of problem drinking, and tryptophan availability. Results:, On subjective "urge to drink" and "crave for a drink," we found a significant (p < 0.05) main effect of genotype and cue, as well as an interaction among genotype, age of onset of problem drinking, and tryptophan depletion. For the physiological measure of pulse, there was a main effect of genotype. L-carriers had higher craving than their SS counterparts, an effect that decreased under tryptophan depletion. While craving in L-carriers increased with an earlier age of onset of problem drinking, the opposite effect was seen in those with the SS genotype. Conclusion:, These results not only provide support for the hypothesis that alcoholics who are L-carriers have greater alcohol craving and possibly greater propensity for drinking but also propose that there is an important 5-HTT gene-by-environment interaction that alters cue craving response for alcohol. [source] Avoidance of Alcohol-Related Stimuli in Alcohol-Dependent InpatientsALCOHOLISM, Issue 8 2007J. M. Townshend Background: Previous research has shown an attentional bias toward drug-related stimuli in heavy social drinkers. Attentional orientation to drug-related cues may lead to increased craving and preoccupation with the drug and impaired ability to focus attention on nondrug-related activities, resulting in renewed drug taking or relapse from drug abstinence. Objective: The aim of this study was to investigate whether alcohol-dependent inpatients would differ in their selective attention toward alcohol-related stimuli in comparison with a group of social drinking controls. Method: Thirty-five alcohol-dependent inpatients were compared with a group of 39 social drinking controls matched for age, sex, and verbal IQ. Attentional bias was assessed using alcohol-related pictures in a dot probe detection task. Questionnaires were used to examine outcome expectancies after alcohol consumption, anxiety, mood, and craving. Results: The alcoholic inpatients showed a bias away from the alcohol-related stimuli, scored higher on alcohol outcome expectancies, and on anxiety measures (both state and trait). They also presented with more negative mood compared with the control group. Craving was higher in the alcoholic group for the factor "loss of control over drinking." Conclusions: Alcoholic inpatients undergoing treatment based on the 12-step treatment of Alcoholics Anonymous (Minnesota model), which includes counseling, and intensive group, individual, and family psychotherapy, show an avoidance for drug-related stimuli and a perception of loss of control over drinking. We suggest that their increased perception of loss of control over drinking produces the avoidance from the drug-related stimuli. [source] A Functional Polymorphism of the , -Opioid Receptor Gene (OPRM1) Influences Cue-Induced Craving for Alcohol in Male Heavy DrinkersALCOHOLISM, Issue 1 2007Esther Van Den Wildenberg Background: The , -opioid receptor gene (OPRM1) codes for the , -opioid receptor, which binds , -endorphin. The A118G polymorphism in this gene affects , -endorphin binding such that the Asp40 variant (G allele) binds , -endorphin 3 times more tightly than the more common Asn40 variant (A allele). This study investigated the influence of the A118G polymorphism on cue reactivity after exposure to an alcoholic beverage in male heavy drinkers. Methods: Participants were either homozygous for the A allele (n=84) or carrying at least 1 copy of the G allele (n=24). All participants took part in a cue-reactivity paradigm where they were exposed to water and beer in 3-minute trials. The dependent variables of main interest were subjective craving for alcohol, subjective arousal, and saliva production. Results: G allele carriers reported significantly more craving for alcohol than the A allele participants (as indicated by the within-subject difference in craving after beer vs after water exposure). No differences were found for subjective arousal and saliva. Both groups did not differ in family history of alcoholism. Participants with the G allele reported a significantly higher lifetime prevalence of drug use than participants homozygous for the A allele. Conclusions: A stronger urge to drink alcohol after exposure to an alcoholic beverage might contribute to a heightened risk for developing alcohol-related problems in individuals with a copy of the G allele. The G allele might also predispose to drug use in general. [source] An in vivo Study of the Relationship between Craving and Reaction Time during Alcohol Detoxification Using the Ecological Momentary AssessmentALCOHOLISM, Issue 12 2005M Lukasiewicz Abstract: Background: To study cognitive interference associated with craving for alcohol, the Ecological Momentary Assessment (EMA) method was used to measure the relationship between craving and reaction time. A secondary aim was the study of the predictive factors for craving during alcohol detoxification. The EMA enables both repeated measures of craving in a natural setting and the recording of reaction time without the patient being aware of this. Methods: Craving for alcohol, reaction time, sadness and anxiety were recorded 8 to 12 times a day, over three weeks of detoxification in 14 alcoholics (n= 1767 measures), on an electronic diary issuing random prompts. Mixed models were used for statistical analysis (,= 5%, 1-,= 88%). Results: Reaction time was significantly increased in univariate analysis when a craving episode occurred but this difference did not persist after multivariate analysis. Craving episodes were more frequent and intense than previously reported. Predictive factors of craving during detoxification were: age, gender, sadness, anxiety and the number of previous detoxifications. Antidepressants, anticraving medications but not benzodiazepines were negatively associated to craving. [source] Building Bridges: The Transdisciplinary Study of Craving From the Animal Laboratory to the LamppostALCOHOLISM, Issue 2 2004Peter M. Monti Abstract: This article represents the proceedings of a symposium at the 2003 Research Society on Alcoholism meeting in Ft. Lauderdale, Florida, organized and chaired by Peter M. Monti. The presentations and presenters were (1) Alcohol Seeking and Self-Administration in Rats: The Role of Serotonin Activity, by Cristine L. Czachowski; (2) Assessing Binge Drinking in Monkeys, by Kathleen A. Grant; (3) Craving and the Perception of Time, by Michael Sayette; (4) Ecological and Laboratory Assessment of Alcohol Urges and Drinking: Effects of Naltrexone, by Peter M. Monti; and (5) Discussion, by Damaris J. Rohsenow. [source] Effect of Tryptophan Depletion on Alcohol Cue-Induced Craving in Abstinent Alcoholic PatientsALCOHOLISM, Issue 8 2001Ismene L. Petrakis Background: The capacity of alcohol cues to precipitate the desire to drink may be an important determinant of relapse to alcohol use in recovering alcohol-dependent patients. This study evaluated whether attenuation of serotonin synthesis via depletion of its precursor tryptophan reduces the magnitude of cue-induced craving for alcohol in recently abstinent alcoholic individuals. Methods: Alcohol-dependent patients (n= 16), 1 to 3 months after detoxification, who exhibited a 20% or greater increase in reported craving when presented with an alcoholic beverage, completed two additional alcohol cue-exposure test days, 1 week apart. Each cue exposure was preceded by administration of a concentrated amino acid drink that resulted in a rapid and significant decline in plasma free tryptophan (active depletion, no tryptophan supplementation) or a similar drink containing tryptophan (placebo depletion). Tests were conducted in a randomized, double-blind fashion. Results: There were no significant changes in the magnitude of cue-induced craving with active tryptophan depletion compared with placebo. Conclusions: These data question the dependence of alcohol cue-induced craving in sober alcoholics on the ongoing synthesis of serotonin. [source] Daily Sessions of Transcranial Magnetic Stimulation to the Left Prefrontal Cortex Gradually Reduce Cocaine CravingTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2008Ernestina Politi MD No abstract is available for this article. [source] Symptom Severity, Alcohol Craving, and Age of Trauma Onset in Childhood and Adolescent Trauma Survivors with Comorbid Alcohol Dependence and Posttraumatic Stress DisorderTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 6 2006Julie A. Schumacher PhD Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) are frequently comorbid disorders. Given evidence that childhood traumas may be associated with broader, more severe psychological sequelae than later traumas, the present study examined whether the association between alcohol and trauma symptomatology is more pronounced among individuals with earlier trauma onsets in a sample of 42 childhood and adolescent trauma survivors diagnosed with comorbid AD-PTSD. As predicted, individuals reporting childhood traumas reported greater severity of trauma and alcohol symptoms and greater alcohol craving. These results suggest that individuals with childhood trauma histories may be particularly vulnerable to relapse following AD treatment. [source] Effects of lamotrigine in patients with bipolar disorder and alcohol dependenceBIPOLAR DISORDERS, Issue 3 2006Gabriel Rubio Background:, Bipolar disorder is significantly associated with alcohol use disorders. Anticonvulsant drugs are used in the treatment of bipolar disorder and they have also been used to treat alcohol dependence. The purpose of the present study was to evaluate tolerance and safety of lamotrigine in a dual-diagnosis population presenting bipolar disorder and alcohol dependence. Open-label lamotrigine was examined in 28 outpatients with DSM-IV bipolar disorder and alcohol dependence. Lamotrigine was added to existing medication regimens. Method:, Lamotrigine was started at a dose of 25 mg/day and titrated to a maximum dose of 300 mg/day. Subjects received a baseline evaluation which included a Structured Clinical Interview for DSM-IV (SCID) and weekly assessments for 12 weeks with the Hamilton Rating Scale for Depression (HAM-D), Young Mania Rating Scale (YMRS), Brief Psychiatric Rating Scale (BPRS), Severity of Alcohol Dependence Scale (SADS), a Visual Analogue Scale for Craving severity (VASC), and alcohol consumption. The concentration of carbohydrate-deficient transferrin (CDT) was used as an indirect measure of alcohol consumption. The sample consisted of 18 men and 10 women diagnosed with alcohol dependence and bipolar disorder I (n = 21) or bipolar disorder II (n = 7), with a mean age of 36.5 ± 7.7 years. Results:, Significant improvement was observed in HAM-D, YMRS, and BPRS scores (p < 0.01). Craving and CDT also significantly decreased (p < 0.001). Lamotrigine was well tolerated with no dropout subjects due to adverse events. Conclusion:, Lamotrigine is safe and well tolerated in this sample and associated with improvement in mood, alcohol craving and alcohol consumption. A placebo-controlled study would be of interest. [source] Hormones and drinking behaviour: New findings on ghrelin, insulin, leptin and volume-regulating hormones.DRUG AND ALCOHOL REVIEW, Issue 2 2009An ESBRA Symposium report Abstract There is growing evidence for a role of appetite-related peptides and volume-regulating hormones in alcoholism. In particular, recent evidence has suggested that hormones, such as ghrelin, insulin and leptin and volume-regulating hormones, could play a role in alcohol-seeking behaviour. The goal of this review is to discuss the results of recent preclinical and clinical investigations on this topic. The findings indicate that neuroendocrinological mechanisms are potentially involved in the neurobiology of alcohol craving. Accordingly, research on this topic could lead to possible development of new therapeutic approaches in the treatment of patients with alcohol problems. [Addolorato G, Leggio L, Hillemacher T, Kraus T, Jerlhag E, Bleich S. Hormones and drinking behaviour: New findings on ghrelin, insulin, leptin and volume-regulating hormones. An ESBRA Symposium report. Drug Alcohol Rev 2009] [source] Initial, habitual and compulsive alcohol use is characterized by a shift of cue processing from ventral to dorsal striatumADDICTION, Issue 10 2010Sabine Vollstädt-Klein ABSTRACT Aims During the development of drug addiction, initial hedonic effects decrease when substance use becomes habitual and ultimately compulsive. Animal research suggests that these changes are represented by a transition from prefrontal cortical control to subcortical striatal control and within the striatum from ventral to dorsal domains of the striatum, but only limited evidence exists in humans. In this study we address this hypothesis in the context of alcohol dependence. Design, setting and participants Non-abstinent heavy social drinkers (n = 21, 5.0 ± 1.5 drinks/day, 13 of them were alcohol-dependent according to DSM-IV) and light social drinkers (n = 10, 0.4 ± 0.4 drinks/day) were examined. Measurements We used a cue-reactivity functional magnetic resonance imaging (fMRI) design during which pictures of alcoholic beverages and neutral control stimuli were presented. Findings In the dorsal striatum heavy drinkers showed significant higher activations compared to light drinkers, whereas light social drinkers showed higher cue-induced fMRI activations in the ventral striatum and in prefrontal areas compared to heavy social drinkers [region of interest analyses, P < 0.05 false discovery rate (FDR)-corrected]. Correspondingly, ventral striatal activation in heavy drinkers correlated negatively with obsessive-compulsive craving, and furthermore we found a positive association between cue-induced activation in the dorsal striatum and obsessive-compulsive craving in all participants. Conclusions In line with our hypothesis we found higher cue-induced activation of the ventral striatum in social compared to heavy drinkers, and higher dorsal striatal activation in heavy drinkers. Increased prefrontal activation may indicate that social drinkers activate cortical control when viewing alcohol cues, which may prevent the development of heavy drinking or alcohol dependence. Our results suggest differentiating treatment research depending on whether alcohol use is hedonic or compulsive. [source] Withdrawal symptoms in abstinent methamphetamine-dependent subjectsADDICTION, Issue 10 2010Todd Zorick ABSTRACT Aims Withdrawal symptoms have been linked to a propensity for relapse to drug abuse. Inasmuch as this association applies to methamphetamine (MA) abuse, an understanding of the course of MA withdrawal symptoms may help to direct treatment for MA dependence. Previous studies of symptoms manifested during abstinence from MA have been limited in size and scope. We asked (i) whether debilitating psychological and/or physical symptoms appear during the first several weeks of MA abstinence, (ii) how craving for MA evolves and (iii) whether psychiatric symptoms (e.g. depression, psychosis) persist beyond a month of abstinence. Design A study of MA-dependent participants, who initiated and maintained abstinence from the drug for up to 5 weeks, compared to a matched healthy comparison group. Setting In-patient research hospital ward (MA-dependent subjects) and out-patient (comparison subjects). Participants Fifty-six MA-dependent and eighty-nine comparison subjects. Measurements Rater-assessed MA withdrawal questionnaire and self-report assessment of craving (MA-dependent subjects) and self-report assessment of psychiatric symptoms (both groups). Findings At study entry, MA-dependent subjects exhibited a wide range in severity of depressive symptoms, with the average score at a mild,moderate level of severity. Symptoms of psychosis were also prevalent. While depressive and psychotic symptoms largely resolved within a week of abstinence, craving did not decrease significantly from the time of initiating abstinence until the second week, and then continued at a reduced level to the fifth week. Conclusions Depressive and psychotic symptoms accompany acute withdrawal from methamphetamine but resolve within 1 week. Craving is also present and lasts at least 5 weeks. [source] Behavioral economic analysis of cue-elicited craving for alcoholADDICTION, Issue 9 2010James MacKillop ABSTRACT Aims Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. Design One-way within-subjects design. Setting Human laboratory environment. Participants Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. Assessments Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. Findings Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (Omax), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized Pmax). Craving was significantly correlated with demand measures at levels ranging from 0.21,0.43. Conclusions These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving. [source] A randomized trial of the effects of two novel nicotine replacement therapies on tobacco withdrawal symptoms and user satisfactionADDICTION, Issue 7 2010Hayden McRobbie ABSTRACT Aims To determine effects on craving, user satisfaction, and consumption patterns of two new nicotine replacement therapies (NRT) used for eight hours after overnight tobacco abstinence. Design In a within-subject, cross-over trial participants were randomly assigned Zonnic® nicotine mouth spray (1 mg/spray), Zonnic® nicotine lozenge (2.5 mg), Nicorette® gum (4 mg) and placebo lozenge on each of four study days. Setting University research unit. Participants Forty-seven dependent adult smokers. Measurements Participants rated their urges to smoke, irritability, concentration and restlessness before and during the first hour of product use on a 100-point scale. A subsample of 11 participants provided blood samples for nicotine analysis. Findings All active products reduced craving significantly more than placebo (mean reductions of 28.6, 25.8, 24.7 and 8.9 points for mouth spray, gum, lozenge and placebo). Mouth spray relieved craving faster than placebo and gum with significant reductions within five minutes of use (mean differences of ,14.5 (95% CI: ,23.0 to ,6.0) and ,10.6 (95% CI: ,19.1 to ,2.1) with placebo and gum respectively. Mouth spray produced a faster time to maximum plasma nicotine concentration (14.5 minutes, 95% CI: 8.0 to 21.0) compared to the lozenge (30.3 minutes, 95% CI: 21.1 to 39.5) and gum (45.8 minutes, 95% CI: 36.2 to 55.4). Maximum concentrations of blood nicotine were higher with mouth spray (10.0 ng/ml) and lozenge (10.8 ng/ml) compared to gum (7.8 ng/ml). Both lozenge and mouth spray were well tolerated. Conclusions The mouth spray and lozenge are at least as effective as 4 mg nicotine gum in relieving craving suggesting that they are likely to be effective in aiding smoking cessation. The mouth spray may be particularly useful for acute craving relief. [source] Retraining automatic action-tendencies to approach alcohol in hazardous drinkersADDICTION, Issue 2 2010Reinout W. Wiers ABSTRACT Aims The main aim of this study was to test whether automatic action-tendencies to approach alcohol can be modified, and whether this affects drinking behaviour. Design and participants Forty-two hazardous drinkers were assigned randomly to a condition in which they were implicitly trained to avoid or to approach alcohol, using a training variety of the alcohol Approach Avoidance Test (AAT). Participants pushed or pulled a joystick in response to picture-format (landscape or portrait). The pictures depicted alcoholic or non-alcoholic drinks. Participants in the avoid-alcohol condition pushed most alcoholic and pulled most non-alcoholic drinks. For participants in the approach-alcohol condition these contingencies were reversed. After the implicit training, participants performed a taste test, including beers and soft drinks. Automatic action tendencies at post-test were assessed with the AAT, including both trained and untrained pictures, and with a different test (Implicit Association Test, IAT). We further tested effects on subjective craving. Results Action tendencies for alcohol changed in accordance with training condition, with the largest effects in the clinically relevant avoid-alcohol condition. These effects occurred outside subjective awareness and generalized to new pictures in the AAT and to an entirely different test using words, rather than pictures (IAT). In relatively heavy drinking participants who demonstrated changed action tendencies in accordance with their training condition, effects were found on drinking behaviour, with participants in the approach-alcohol condition drinking more alcohol than participants in the avoid-alcohol condition. No effect was found on subjective craving. Conclusions Retraining automatic processes may help to regain control over addictive impulses, which points to new treatment possibilities. [source] Efficacy of repetitive transcranial magnetic stimulation in alcohol dependence: a sham-controlled studyADDICTION, Issue 1 2010Biswa R. Mishra ABSTRACT Objective To study the anticraving efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral pre-frontal cortex (DLPFC) in patients with alcohol dependence. Methods We performed a prospective, single-blind, sham-controlled study involving 45 patients with alcohol dependence syndrome (according to ICD-10 DCR), with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA-Ar) scores ,10. Patients were allocated to active and sham rTMS in a 2 : 1 ratio, such that 30 patients received active and 15 patients sham rTMS to the right DLPFC (10 Hz frequency, 4.9 seconds per train, inter-train interval of 30 seconds, 20 trains per session, total 10 sessions). The Alcohol Craving Questionnaire (ACQ-NOW) was administered to measure the severity of alcohol craving at baseline, after the last rTMS session and after 1 month of the last rTMS session. Results Two-way repeated-measures analysis of variance (ANOVA) showed significant reduction in the post-rTMS ACQ-NOW total score and factor scores in the group allocated active rTMS compared to the sham stimulation. The effect size for treatment with time interaction was moderate (,2 = 0.401). Conclusions Right dorsolateral pre-frontal high-frequency rTMS was found to have significant anticraving effects in alcohol dependence. The results highlight the potential of rTMS which, combined with other anticraving drugs, can act as an effective strategy in reducing craving and subsequent relapse in alcohol dependence. [source] Commentary on Mishra et al. (2010): Transcranial magnetic stimulation effects on craving: impressive therapy or therapeutic impressions?ADDICTION, Issue 1 2010JODIE A. TRAFTON No abstract is available for this article. [source] Influence of smoking cues in movies on craving among smokersADDICTION, Issue 12 2009Kirsten Lochbuehler ABSTRACT Aims Research has shown that smoking-related cues are important triggers for craving. The objective of the present study was to test whether smoking cues in movies also function as triggers to evoke craving. To accomplish this, we conducted a pilot study in which we examined smokers' reactivity to smoking cues from a particular movie in a common cue,reactivity paradigm using pictures. In the main study, we tested whether smokers who are confronted with smoking characters in a movie segment have a greater desire to smoke than smokers confronted with non-smoking characters. Design Using an experimental design, participants were assigned randomly to one of two movie conditions (smoking versus non-smoking characters). Setting In a laboratory, that reflected a naturalistic setting, participants watched a 41-minute movie segment. Participants A total of 65 young adults who smoked on a daily basis participated in the experiment. Measurements Craving was assessed before and after watching the movie. Findings The pilot study revealed that pictures of smoking characters had strong effects on craving. However, when smokers actually watched a movie segment, no differences in craving were found between those who watched smoking characters and those who watched non-smoking characters. This finding was not affected by baseline craving, the time of the last cigarette smoked and daily smoking habits. Conclusions No effect of smoking cues in movies on craving was found, in contrast with research supporting the cue-craving link. Thus, if replicated, this might indicate that smoking cues in such contexts do not affect smokers' desire to smoke as expected. [source] Does smoking cue-induced craving tell us anything important about nicotine dependence?ADDICTION, Issue 10 2009Kenneth A. Perkins ABSTRACT Cue-reactivity, or self-reported craving response to drug-associated stimuli, is an active area of research on factors that maintain drug use, particularly cigarette smoking. A common rationale for this research is the expectation that treatments that extinguish cue-induced craving will be effective as smoking cessation interventions. Therefore, the importance of research on the variables that moderate and control cue-induced craving would seem to hinge upon the relevance of cue-induced craving to nicotine dependence, particularly its association with relapse risk. However, the limited relevant clinical research has not demonstrated clearly a link between smoking relapse risk and self-reported craving in response to smoking cues. Links between relapse and other responses to cues, such as heart rate or electrodermal activity, are inconsistent or not significant. The Food and Drug Administration (FDA)-approved smoking cessation medications have not been shown to alleviate cue-induced craving, although they do alleviate abstinence-induced craving, which has been associated with relapse risk. Nevertheless, other acute measures assessed in the laboratory have been shown to predict subsequent relapse risk in quitting smokers, demonstrating the feasibility of this type of study. Future research may benefit from using more reliable and valid multi-item craving measures, focusing upon more specific conditions under which cue-induced craving may predict relapse and, most importantly, considering dependent measures other than self-reported craving in response to cues, particularly actual smoking behavior. Without stronger evidence in support of the relevance of cue-induced craving response to the persistence of smoking behavior or other measures of dependence, it will be incumbent upon researchers in this area to justify why studies of cue-induced craving contribute to our understanding of dependence. [source] A double-blind, randomized, parallel group study to compare the efficacy, safety and tolerability of slow-release oral morphine versus methadone in opioid-dependent in-patients willing to undergo detoxificationADDICTION, Issue 9 2009Ekkehard Madlung-Kratzer ABSTRACT Aims Evaluation of the efficacy and safety of slow-release oral morphine (SROM) compared with methadone for detoxification from methadone and SROM maintenance treatment. Design Randomized, double-blind, double-dummy, comparative multi-centre study with parallel groups. Setting Three psychiatric hospitals in Austria specializing in in-patient detoxification. Participants Male and female opioid dependents (age > 18 years) willing to undergo detoxification from maintenance therapy in order to reach abstinence. Interventions Abstinence was reached from maintenance treatment by tapered dose reduction of either SROM or methadone over a period of 16 days. Measurements Efficacy analyses were based on the number of patients per treatment group completing the study, as well as on the control of signs and symptoms of withdrawal [measured using Short Opioid Withdrawal Scale (SOWS)] and suppression of opiate craving. In addition, self-reported somatic and psychic symptoms (measured using Symptom Checklist SCL-90-R) were monitored. Findings Of the 208 patients enrolled into the study, 202 were eligible for analysis (SROM: n = 102, methadone: n = 100). Completion rates were 51% in the SROM group and 49% in the methadone group [difference between groups: 2%; 95% confidence interval (CI): ,12% to 16%]. The rate of discontinuation in the study was high mainly because of patients voluntarily withdrawing from treatment. No statistically significant differences between treatment groups were found in terms of signs and symptoms of opiate withdrawal, craving for opiates or self-reported symptoms. SROM and methadone were both well tolerated. Conclusions Detoxification from maintenance treatment with tapered dose reduction of SROM is non-inferior to methadone. [source] | ||||||||||||||||