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Addiction. 2015 Jun;110(6):1035-42. doi: 10.1111/add.12882. Epub 2015 Apr 21.

Craving and substance use among patients with alcohol, tobacco, cannabis or heroin addiction: a comparison of substance- and person-specific cues.

Fatseas M1,2,3,4, Serre F1,2,4, Alexandre JM1,2,4, Debrabant R1,2,4, Auriacombe M1,2,4,5, Swendsen J1,3,6.

Author information

1
Université Bordeaux, Bordeaux, France.
2
Laboratoire de psychiatrie/SANPSY, CNRS USR 3413, Bordeaux, France.
3
INCIA, CNRS UMR 5287, Bordeaux, France.
4
Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France.
5
Center for Studies of Addiction, Department of psychiatry, Perelman School of Medicine, University of Pennsylvania, Phildelphia, PA, USA.
6
Ecole Pratique des Hautes Etudes, Paris, France.

Abstract

BACKGROUND AND AIMS:

It is well established that craving increases following exposure to substance-related 'cues', but the role of life-styles or substance use habits that are unique to each person remains poorly understood. This study examines the association of substance-specific and personal cues with craving and substance use in daily life.

DESIGN:

Ecological momentary assessment was used during a 2-week period.

SETTING:

Data were collected in a French out-patient addiction treatment centre.

PARTICIPANTS:

A total of 132 out-patients beginning treatment for alcohol, tobacco, cannabis or opiate addiction were included.

MEASUREMENTS:

Using mobile technologies, participants were questioned four times per day relative to craving, substance use and exposure to either substance-specific cues (e.g. seeing a syringe) or personal cues unique to that individual (e.g. seeing the specific person with whom the substance is used).

FINDINGS:

Craving intensity was associated with the number of concurrently assessed substance-specific cues (t = 4.418, P < 0.001) and person-specific cues (t = 4.006, P < 0.001) when analysed jointly within the same model. However, only person-specific cues were associated with increases in craving over subsequent hours of the day (t = 2.598, P < 0.05). Craving intensity, in turn, predicted increases in later substance use (t = 4.076, P < 0.001). Causal mediation analyses demonstrated that the association of cues with later substance use was mediated by craving intensity (mediated effect = 0.007, 95% confidence interval = 0.004-0.011).

CONCLUSIONS:

Unique person-specific cues appear to have a robust effect on craving addictive substances, and the duration of this association may persist longer than for more general substance-specific cues. Mobile technologies provide new opportunities for understanding these person-specific risk factors and for providing individually tailored interventions.

KEYWORDS:

Addiction; craving; cues; ecological momentary assessment; experience sampling method; relapse

PMID:
25688760
DOI:
10.1111/add.12882
[Indexed for MEDLINE]

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