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Before and after: craving, mood, and background stress in the hours surrounding drug use and stressful events in patients with opioid-use disorder.
- Source :
-
Psychopharmacology [Psychopharmacology (Berl)] 2018 Sep; Vol. 235 (9), pp. 2713-2723. Date of Electronic Publication: 2018 Jul 07. - Publication Year :
- 2018
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Abstract
- Rationale: Ecological momentary assessment (EMA) of specific events usually focuses more on antecedents and concomitants than on aftermaths.<br />Objectives: To examine mental state both before and after discrete episodes of stress and drug use.<br />Methods: For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated entries for stressful events (SEs) or lapses to drug use (DUs), and thrice daily when randomly prompted (RPs). Participants rated their stress, opioid craving, cocaine craving, and moods. RP entries within 5 h of an event were analyzed and compared to other RPs.<br />Results: Stress, negative mood, and craving were generally higher before and after DUs and SEs compared to background levels in participants with at least one DU (nā=ā149) or SE (nā=ā158). Before DUs, there were increases in negative mood, opioid craving, and cocaine craving, but not background stress. Before SEs, there were increases in background stress, opioid craving, and cocaine craving, but not negative mood. These changes were more variable after events than before. Neither DUs nor SEs were significantly related to positive mood.<br />Conclusions: Stress increased before stressful-event entries, but was less evident before drug use. Craving increased in the hours before drug use and stressful events-and remained elevated in the hours after either event. These results suggest a stronger link between drug use and craving than between drug use and stress. Lapses to drug use did not improve mood or reduce stress, at least not at our 1-h-bin time resolution, suggesting that if such benefits exist, they are brief.
- Subjects :
- Adult
Affect drug effects
Analgesics, Opioid administration & dosage
Analgesics, Opioid adverse effects
Cocaine administration & dosage
Craving drug effects
Female
Humans
Male
Methadone pharmacology
Methadone therapeutic use
Middle Aged
Opiate Substitution Treatment methods
Opiate Substitution Treatment psychology
Opioid-Related Disorders drug therapy
Random Allocation
Stress, Psychological drug therapy
Affect physiology
Cocaine adverse effects
Craving physiology
Opioid-Related Disorders psychology
Smartphone statistics & numerical data
Stress, Psychological psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2072
- Volume :
- 235
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Psychopharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 29980821
- Full Text :
- https://doi.org/10.1007/s00213-018-4966-9