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Günther F, Wong D, Elison-Davies S, Yau C. Identifying factors associated with user retention and outcomes of a digital intervention for substance use disorder: a retrospective analysis of real-world data. JAMIA Open 2023; 6:ooad072. [PMID: 37663407 PMCID: PMC10474970 DOI: 10.1093/jamiaopen/ooad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/29/2023] [Accepted: 08/11/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives Successful delivery of digital health interventions is affected by multiple real-world factors. These factors may be identified in routinely collected, ecologically valid data from these interventions. We propose ideas for exploring these data, focusing on interventions targeting complex, comorbid conditions. Materials and Methods This study retrospectively explores pre-post data collected between 2016 and 2019 from users of digital cognitive behavioral therapy (CBT)-containing psychoeducation and practical exercises-for substance use disorder (SUD) at UK addiction services. To identify factors associated with heterogenous user responses to the technology, we employed multivariable and multivariate regressions and random forest models of user-reported questionnaire data. Results The dataset contained information from 14 078 individuals of which 12 529 reported complete data at baseline and 2925 did so again after engagement with the CBT. Ninety-three percent screened positive for dependence on 1 of 43 substances at baseline, and 73% screened positive for anxiety or depression. Despite pre-post improvements independent of user sociodemographics, women reported more frequent and persistent symptoms of SUD, anxiety, and depression. Retention-minimum 2 use events recorded-was associated more with deployment environment than user characteristics. Prediction accuracy of post-engagement outcomes was acceptable (Area Under Curve [AUC]: 0.74-0.79), depending non-trivially on user characteristics. Discussion Traditionally, performance of digital health interventions is determined in controlled trials. Our analysis showcases multivariate models with which real-world data from these interventions can be explored and sources of user heterogeneity in retention and symptom reduction uncovered. Conclusion Real-world data from digital health interventions contain information on natural user-technology interactions which could enrich results from controlled trials.
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Affiliation(s)
- Franziska Günther
- Division of Informatics, Imaging & Data Sciences, School of Health Sciences, University of Manchester, Manchester M13 9GB, United Kingdom
| | - David Wong
- Division of Informatics, Imaging & Data Sciences, School of Health Sciences, University of Manchester, Manchester M13 9GB, United Kingdom
| | | | - Christopher Yau
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, United Kingdom
- Health Data Research UK, London NW1 2BE, United Kingdom
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Mathieson E, Irving C, Koberna S, Nicholson M, Otto MW, Kantak KM. Role of preexisting inhibitory control deficits vs. drug use history in mediating insensitivity to aversive consequences in a rat model of polysubstance use. Psychopharmacology (Berl) 2022; 239:2377-2394. [PMID: 35391547 PMCID: PMC8989405 DOI: 10.1007/s00213-022-06134-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/30/2022] [Indexed: 10/26/2022]
Abstract
RATIONALE The nature and predictors of insensitivity to aversive consequences of heroin + cocaine polysubstance use are not well characterized. OBJECTIVES Translational methods incorporating a tightly controlled animal model of drug self-administration and measures of inhibitory control and avoidance behavior might be helpful for clarifying this issue. METHODS The key approach for distinguishing potential contributions of pre-existing inhibitory control deficits vs. drug use history in meditating insensitivity to aversive consequences was comparison of two rat strains: Wistar (WIS/Crl), an outbred strain, and the spontaneously hypertensive rat (SHR/NCrl), an inbred strain shown previously to exhibit heightened cocaine and heroin self-administration and poor inhibitory control relative to WIS/Crl. RESULTS In separate tasks, SHR/NCrl displayed greater impulsive action and compulsive-like behavior than WIS/Crl prior to drug exposure. Under two different schedules of drug delivery, SHR/NCrl self-administered more cocaine than WIS/Crl, but self-administered a similar amount of heroin + cocaine as WIS/Crl. When half the session cycles were punished by random foot shock, SHR/NCrl initially were less sensitive to punishment than WIS/Crl when self-administering cocaine, but were similarly insensitive to punishment when self-administering heroin + cocaine. Based on correlation analyses, only trait impulsivity predicted avoidance capacity in rats self-administering cocaine and receiving yoked-saline. In contrast, only amount of drug use predicted avoidance capacity in rats self-administering heroin + cocaine. Additionally, baseline drug seeking and taking predicted punishment insensitivity in rats self-administering cocaine or heroin + cocaine. CONCLUSIONS Based on the findings revealed in this animal model, human laboratory research concerning the nature and predictors of insensitivity to aversive consequences in heroin and cocaine polysubstance vs. monosubstance users is warranted.
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Affiliation(s)
- Elon Mathieson
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Carolyn Irving
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Sarah Koberna
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Megan Nicholson
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Kathleen M Kantak
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA.
- Center for Systems Neuroscience, Boston University, Boston, MA, USA.
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A neuroeconomic signature of opioid craving: How fluctuations in craving bias drug-related and nondrug-related value. Neuropsychopharmacology 2022; 47:1440-1448. [PMID: 34916590 PMCID: PMC9205977 DOI: 10.1038/s41386-021-01248-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022]
Abstract
How does craving bias decisions to pursue drugs over other valuable, and healthier, alternatives in addiction? To address this question, we measured the in-the-moment economic decisions of people with opioid use disorder as they experienced craving, shortly after receiving their scheduled opioid maintenance medication and ~24 h later. We found that higher cravers had higher drug-related valuation, and that moments of higher craving within-person also led to higher drug-related valuation. When experiencing increased opioid craving, participants were willing to pay more for personalized consumer items and foods more closely related to their drug use, but not for alternative "nondrug-related" but equally desirable options. This selective increase in value with craving was greater when the drug-related options were offered in higher quantities and was separable from the effects of other fluctuating psychological states like negative mood. These findings suggest that craving narrows and focuses economic motivation toward the object of craving by selectively and multiplicatively amplifying perceived value along a "drug relatedness" dimension.
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Butelman ER, Chen CY, Lake KJ, Brown KG, Kreek MJ. Bidirectional influence of heroin and cocaine escalation in persons with dual opioid and cocaine dependence diagnoses. Exp Clin Psychopharmacol 2022; 30:31-38. [PMID: 33119382 PMCID: PMC8388238 DOI: 10.1037/pha0000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Persons with dual severe opioid and cocaine use disorders are at risk of considerable morbidity, and the bidirectional relationship of escalation of mu-opioid agonists and cocaine use is not well understood. The aim of this study was to examine the bidirectional relationship between escalation of heroin and cocaine use in volunteers dually diagnosed with opioid and cocaine dependence (OD + CD). Volunteers from New York with OD + CD (total n = 295; male = 182, female = 113; age ≥ 18 years) were interviewed with the Structured Clinical Interview for the DSM-IV Axis I Disorders and Kreek-McHugh-Schluger-Kellogg scales for dimensional measures of drug exposure, which also collect ages of 1st use and onset of heaviest use. Time of escalation was defined as age of onset of heaviest use minus age of 1st use in whole years. Times of escalation of heroin and cocaine were positively correlated in both men (Spearman r = .34, 95% confidence interval [CI: .17, .48], p < .0001) and women (Spearman r = .51, [.27, .50], p < .0001) volunteers. After we adjusted for demographic variables, a Cox regression showed that time of cocaine escalation was a predictor of time of heroin escalation (hazard ratio [HR] = 0.97, 95% CI [0.95, 0.99], p = .003). Another Cox regression showed that this relationship is bidirectional, because time of heroin escalation was also a predictor of time of cocaine escalation (HR = 0.98, [0.96-0.99], p = .016). In these adjusted models, gender was not a significant predictor of time of escalation of either heroin or cocaine. Therefore, escalation did not differ robustly by gender when adjusting for demographics and other major variables. Overall, rapid escalation of cocaine use was a predictor of rapid escalation of heroin use, and vice versa, in persons with dual severe opioid and cocaine use disorders. These findings suggest a shared vulnerability to rapid escalation of these 2 drugs in persons with dual severe opioid and cocaine use disorders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Jenkins GJ, Cleveland MJ, Knapp KS, Bunce SC, Cleveland HH. Examining the time-varying association of negative affect and covariates with craving during treatment for prescription opioid dependence with two types of mixed models. Addict Behav 2021; 113:106674. [PMID: 33049429 DOI: 10.1016/j.addbeh.2020.106674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 01/24/2023]
Abstract
Opioid use disorders are chronic and relapse is common. Both negative affect and craving have been suggested antecedents of relapse and have been shown to demonstrate within- and between-person variability, as well as association with each other. The present study extends previous research by examining the covariation of negative affect and craving both within-day and at the person-level during 12 days of treatment among opioid-dependent patients. Ecological momentary assessment (EMA) data were collected from 73 participants starting between 10 and 14 days after admission to an inpatient treatment facility. These data were analyzed using multivariate multilevel models and time-varying effect models. Results demonstrated strong association between negative affect and craving. Within-day, negative affect and craving were most associated in the early afternoon. At the person-level, association between negative affect and craving declined during the first week of data collection. Following this initial decline in association, negative affect and craving increasingly covaried during days 8-12 of data collection. To our knowledge, this is the first study to report a lagged increase in the association between negative affect and craving among patients during inpatient treatment for opioid dependence. Implications for research and treatment providers are discussed.
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Crummy EA, Donckels EA, Baskin BM, Bentzley BS, Ferguson SM. The impact of cocaine and heroin drug history on motivation and cue sensitivity in a rat model of polydrug abuse. Psychopharmacology (Berl) 2020; 237:55-68. [PMID: 31463541 PMCID: PMC7458349 DOI: 10.1007/s00213-019-05349-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/09/2019] [Indexed: 11/30/2022]
Abstract
RATIONALE Comorbid use of heroin and cocaine is highly prevalent among drug users and can greatly increase addiction risk. Nonetheless, little is known regarding how a multi-drug history impacts motivation and cue responsivity to individual drugs. OBJECTIVE We used behavioral-economic procedures to examine motivation to maintain drug consumption and tests of drug-seeking to drug-associated cues to assess sensitivity to heroin and cocaine-associated cues in rats that had a self-administration history of heroin, cocaine, or both drugs. RESULTS Unexpectedly, we found that groups with a polydrug history of heroin and cocaine did not have higher levels of motivation or cue-induced reinstatement of drug-seeking for either cocaine or heroin compared to single drug groups. Nonetheless, we did find drug-specific differences in both economic price and cue sensitivity. Specifically, demand elasticity was lower for cocaine compared to heroin in animals with a single drug history, but not with polydrug groups. In addition, cocaine demand was predictive of the degree of cue-induced reinstatement of drug-seeking for cocaine following extinction, whereas heroin demand was predictive of the degree of reactivity to a heroin-associated cue. Furthermore, although cue reactivity following the initial self-administration phase did not differ across cues and drug history, reactivity to both heroin and cocaine cues was greater during subsequent heroin use compared to cocaine use, and this enhanced reactivity to heroin cues persisted during forced abstinence. CONCLUSIONS These results indicate that there is a greater motivation to maintain cocaine consumption, but higher sensitivity to drug-associated cues with a history of heroin use, suggesting that cocaine and heroin may drive continued drug use through different behavioral processes.
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Affiliation(s)
- Elizabeth A. Crummy
- Neuroscience Graduate Program, University of Washington, Seattle, WA, USA,Center for Integrative Brain Research, Seattle Children’s Research Institute, 1900 Ninth Ave., Seattle, WA 98101, USA
| | - Elizabeth A. Donckels
- Center for Integrative Brain Research, Seattle Children’s Research Institute, 1900 Ninth Ave., Seattle, WA 98101, USA
| | - Britahny M. Baskin
- Neuroscience Graduate Program, University of Washington, Seattle, WA, USA,Center for Integrative Brain Research, Seattle Children’s Research Institute, 1900 Ninth Ave., Seattle, WA 98101, USA
| | - Brandon S. Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Susan M. Ferguson
- Neuroscience Graduate Program, University of Washington, Seattle, WA, USA,Center for Integrative Brain Research, Seattle Children’s Research Institute, 1900 Ninth Ave., Seattle, WA 98101, USA,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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Bertz JW, Epstein DH, Reamer D, Kowalczyk WJ, Phillips KA, Kennedy AP, Jobes ML, Ward G, Plitnick BA, Figueiro MG, Rea MS, Preston KL. Sleep reductions associated with illicit opioid use and clinic-hour changes during opioid agonist treatment for opioid dependence: Measurement by electronic diary and actigraphy. J Subst Abuse Treat 2019; 106:43-57. [PMID: 31540611 DOI: 10.1016/j.jsat.2019.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 01/15/2023]
Abstract
Sleep problems are commonly reported during opioid agonist treatment (OAT) for opioid use disorders. Inpatient studies have found both sleep disturbances and improved sleep during OAT. Illicit opioids can also disrupt sleep, but it is unclear how they affect sleep in outpatients receiving OAT. Therefore, we used electronic diary entries and actigraphy to measure sleep duration and timing in opioid-dependent participants (n = 37) treated with methadone (n = 15) or buprenorphine (n = 22). For 16 weeks, participants were assigned to attend our clinic under different operating hours in a crossover design: Early hours (07:00-09:00) vs. Late hours (12:00-13:00) for 4 weeks each in randomized order, followed for all participants by our Standard clinic hours (07:00-11:30) for 8 weeks. Throughout, participants made daily electronic diary self-reports of their sleep upon waking; they also wore a wrist actigraph for 6 nights in each of the three clinic-hour conditions. Drug use was assessed by thrice-weekly urinalysis. In linear mixed models controlling for other sleep-relevant factors, sleep duration and timing differed by drug use and by clinic hours. Compared to when non-using, participants slept less, went to bed later, and woke later when using illicit opioids and/or both illicit opioids and cocaine. Participants slept less and woke earlier when assigned to the Early hours. These findings highlight the role OAT clinic schedules can play in structuring the sleep/wake cycles of OAT patients and clarify some of the circumstances under which OAT patients experience sleep disruption in daily life.
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Affiliation(s)
- Jeremiah W Bertz
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA.
| | - David H Epstein
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - David Reamer
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - William J Kowalczyk
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Karran A Phillips
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Ashley P Kennedy
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Michelle L Jobes
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Greg Ward
- Rensselaer Polytechnic Institute, Lighting Research Center, Troy, NY, USA
| | - Barbara A Plitnick
- Rensselaer Polytechnic Institute, Lighting Research Center, Troy, NY, USA
| | - Mariana G Figueiro
- Rensselaer Polytechnic Institute, Lighting Research Center, Troy, NY, USA
| | - Mark S Rea
- Rensselaer Polytechnic Institute, Lighting Research Center, Troy, NY, USA
| | - Kenzie L Preston
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
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Dunbar MS, Shiffman S, Chandra S. Exposure to workplace smoking bans and continuity of daily smoking patterns on workdays and weekends. Addict Behav 2018; 80:53-58. [PMID: 29348060 DOI: 10.1016/j.addbeh.2018.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/03/2018] [Accepted: 01/05/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Individuals may compensate for workplace smoking bans by smoking more before or after work, or escaping bans to smoke, but no studies have conducted a detailed, quantitative analysis of such compensatory behaviors using real-time data. METHODS 124 daily smokers documented smoking occasions over 3weeks using ecological momentary assessment (EMA), and provided information on real-world exposure to smoking restrictions and type of workplace smoking policy (full, partial, or no bans). Mixed modeling and generalized estimating equations assessed effects of time of day, weekday (vs weekend), and workplace policy on mean cigarettes per hour (CPH) and reports of changing location to smoke. RESULTS Individuals were most likely to change locations to smoke during business hours, regardless of work policy, and frequency of EMA reports of restrictions at work was associated with increased likelihood of changing locations to smoke (OR=1.11, 95% CI 1.05-1.16; p<0.0001). Workplace smoking policy, time block, and weekday/weekend interacted to predict CPH (p<0.01), such that individuals with partial work bans -but not those with full bans - smoked more at night (9pm - bed) on weekdays compared to weekends. CONCLUSIONS There was little evidence that full bans interfered with subjects' smoking during business hours across weekdays and weekends. Smokers largely compensate for exposure to workplace smoking bans by escaping restrictions during business hours. Better understanding the effects of smoking bans on smoking behavior may help to improve their effectiveness and yield insights into determinants of smoking in more restrictive environments.
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Affiliation(s)
- Michael S Dunbar
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA.
| | - Saul Shiffman
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - Siddharth Chandra
- Michigan State University, Department of Epidemiology and Biostatistics, East Lansing, MI, USA
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Jones KK, Zenk SN, McDonald A, Corte C. Experiences of African-American Women with Smartphone-Based Ecological Momentary Assessment. Public Health Nurs 2015; 33:371-80. [PMID: 26530781 DOI: 10.1111/phn.12239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Smartphone-based ecological momentary assessment (EMA), or real-time, repeated sampling of participants' states, behaviors, or experiences over time, is a promising approach to understanding obesity-related behaviors in African-American women-a population with the highest obesity prevalence. In this study, we explored participants' experiences with this methodology. DESIGN AND SAMPLE In this secondary analysis of data, 100 African-American women participated in seven consecutive days of EMA data collection. MEASURES Measures related to acceptability (technical challenges, daily burden, emotional responses, willingness to participate in future studies) and data quality (reporting accuracy, behavior reactivity, adherence), as well as demographics, were collected. RESULTS While there were few demographic differences, women who were unemployed, had the lowest educational levels, or had the lowest per capita income reported the greatest enjoyment with mobile technology-based EMA, while at the same time reporting the highest levels of challenge with use of the equipment. Participants consistently indicated willingness to participate in future EMA studies and indicated that the study method was acceptable. EMA methodology produced data of sufficient quality. CONCLUSION Findings suggest future studies using smartphone-based EMA with African-American women are feasible.
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Affiliation(s)
- Kelly K Jones
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Shannon N Zenk
- College of Nursing, Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
| | - Ashley McDonald
- Department of Psychology, Pennsylvania State University, State College, Pennsylvania
| | - Colleen Corte
- College of Nursing, Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
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Serre F, Fatseas M, Swendsen J, Auriacombe M. Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review. Drug Alcohol Depend 2015; 148:1-20. [PMID: 25637078 DOI: 10.1016/j.drugalcdep.2014.12.024] [Citation(s) in RCA: 215] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Craving is viewed as a major determinant of relapse in persons with substance addiction, but this association remains poorly understood due to its time-limited nature and the biases associated with retrospective reporting. Ecological momentary assessment (EMA) offers new opportunities to examine both craving and substance use with strong ecological validity by collecting real-time data in daily life. This review examined all published studies using EMA to: (1) assess the link between craving and substance use; and (2) identify relevant moderators of craving among substance users. METHODS We searched PubMed and PsycInfo databases up to October 31, 2013. RESULTS Ninety-one studies were selected, involving mostly tobacco smokers (73%). A majority of studies (92%) reported a positive relationship between craving and substance use, concurrently and prospectively, and among users with different levels of use for both legal and illegal substances. Results suggest that craving is a stronger predictor of relapse episodes when assessed in close temporal proximity to substance use. EMA data also confirmed the influence of diverse within-person and between-person sources of variation in daily life craving reports. CONCLUSIONS This review provides strong support for the link between craving and substance use, and underscores the importance of the timing of assessments.
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Affiliation(s)
- Fuschia Serre
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France
| | - Melina Fatseas
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; INCIA, CNRS UMR 5287, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France
| | - Joel Swendsen
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; INCIA, CNRS UMR 5287, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Ecole Pratique des Hautes Etudes, 75014 Paris, France
| | - Marc Auriacombe
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Moore DJ, Montoya JL, Blackstone K, Rooney A, Gouaux B, Georges S, Depp CA, Atkinson JH, TMARC Group T. Preliminary Evidence for Feasibility, Use, and Acceptability of Individualized Texting for Adherence Building for Antiretroviral Adherence and Substance Use Assessment among HIV-Infected Methamphetamine Users. AIDS Res Treat 2013; 2013:585143. [PMID: 24078868 PMCID: PMC3776360 DOI: 10.1155/2013/585143] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 06/21/2013] [Accepted: 06/26/2013] [Indexed: 11/17/2022] Open
Abstract
The feasibility, use, and acceptability of text messages to track methamphetamine use and promote antiretroviral treatment (ART) adherence among HIV-infected methamphetamine users was examined. From an ongoing randomized controlled trial, 30-day text response rates of participants assigned to the intervention (individualized texting for adherence building (iTAB), n = 20) were compared to those in the active comparison condition (n = 9). Both groups received daily texts assessing methamphetamine use, and the iTAB group additionally received personalized daily ART adherence reminder texts. Response rate for methamphetamine use texts was 72.9% with methamphetamine use endorsed 14.7% of the time. Text-derived methamphetamine use data was correlated with data from a structured substance use interview covering the same time period (P < 0.05). The iTAB group responded to 69.0% of adherence reminder texts; among those responses, 81.8% endorsed taking ART medication. Standardized feedback questionnaire responses indicated little difficulty with the texts, satisfaction with the study, and beliefs that future text-based interventions would be helpful. Moreover, most participants believed the intervention reduced methamphetamine use and improved adherence. Qualitative feedback regarding the intervention was positive. Future studies will refine and improve iTAB for optimal acceptability and efficacy. This trial is registered with ClinicalTrials.gov NCT01317277.
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Affiliation(s)
- David J. Moore
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
| | - Jessica L. Montoya
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA
| | - Kaitlin Blackstone
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA
| | - Alexandra Rooney
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
| | - Ben Gouaux
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
| | - Shereen Georges
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
| | - Colin A. Depp
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- VA, San Diego Healthcare System, San Diego, CA 92161, USA
| | - J. Hampton Atkinson
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
- VA, San Diego Healthcare System, San Diego, CA 92161, USA
| | - The TMARC Group
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA 92103, USA
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