Elsevier

Addictive Behaviors

Volume 31, Issue 12, December 2006, Pages 2292-2297
Addictive Behaviors

Short communication
Predicting craving among cocaine users

https://doi.org/10.1016/j.addbeh.2006.02.022Get rights and content

Abstract

Introduction

Craving for cocaine seems to play an important role in the continued use of and dependence on the substance.

Aims

to describe characteristics of the craving phenomenon in a sample of cocaine users and to identify those that could predict the appearance of the phenomenon.

Method

205 cocaine users attending an outpatient clinic were interviewed to assess patterns of drug consumption and characteristics of craving for the drug.

Findings

Subjects were mostly young (24.8 ± 12.8 years) and male (86.2%). One hundred and two subjects (49.8%) were addicted to cocaine and the remainders (50.2%) were non-addicted occasional cocaine users. The majority of subjects (60.5%) reported having had craving episodes during the previous week. Frequency of cocaine use during the previous month correlated with the number of reported craving fits (r = 0.425; p < 0.001) and with the duration of the craving fits (r = 0.351; p < 0.001). Users of crack reported more craving episodes than did the users of snorted cocaine (p < 0.001) and the frequency of craving fits was inversely proportional to the duration of abstinence from the drug (r =  0.405; p < 0.001).

Conclusion

Both the method of drug consumption and the abstinence period elapsed since previous drug intake were identified as predictive parameters of craving.

Introduction

Cocaine is considered one of the most harmful psychoactive abused substances (Rowbotham, 1993). Neurovascular complications due to the use of cocaine can be held responsible for the elevated indices of morbidity and mortality observed among young users. Cases of neurovascular pathology among cocaine dependents are well documented (Levine et al., 1987). Even asymptomatic users have provided evidence of alterations in the cerebral perfusion, as demonstrated in recent studies involving functional tomography techniques (Da Silveira et al., 2001, Strickland et al., 1993).

“Craving” may be described as a complex and subjective phenomenon which can be observed in many cocaine and crack users and assumed to be the major reason responsible both for the continuance of their dependency behavior and for their relapses (Gawin & Kleber, 1994). The subjective experience of craving suggests that one is dealing with a heterogeneous phenomenon (Tiffany, Singleton, Haertzen, & Henningfeld, 1993), there being evidence of major variations in the occurrence of craving amongst abstaining ex-users (Sayette et al., 2000).

In the face of such questions our proposal was to investigate characteristics of the craving phenomenon among cocaine users in our environment.

Section snippets

Sample

The sample involved 205 outpatients who had sought for help at the Addiction Unit of the Psychiatry Department of the Federal University of São Paulo (PROAD). The only criterion for inclusion was the use of cocaine during the two-year period preceding evaluation.

Instruments and procedures

Patients were individually interviewed. Information was collected in a systematized manner on demographic data, diagnosis of the dependence following the criteria of the DSM-IV (American Psychiatric Association, 1994), and questions

Results

One hundred and seventy-eight (86.2%) patients were male and 27 (12.8%) were female, their mean age being 24.8 + 7.5 years. One hundred and two (49.8%) fulfilled diagnostic criteria for cocaine dependence.

Discussion

This study allowed a deep examination of the urge seeking for cocaine, denominated craving, within a sample of dependent and non-dependent cocaine users. In our investigation, the frequency of craving was related to the frequency of cocaine use and to the period of abstinence from the drug. Occasional cocaine users did not report having had craving episodes during the week that preceded the study. However, among the recent users (last thirty days) the proportion of those who did report having

Acknowledgements

This study was funded by the Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil (FAPESP).

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