TY - JOUR
T1 - Stress in the daily lives of cocaine and heroin users
T2 - Relationship to mood, craving, relapse triggers, and cocaine use
AU - Preston, Kenzie L.
AU - Epstein, David H.
N1 - Funding Information:
Funding/support This research was supported by the NIDA Intramural Research Program and Genes and Environment Initiative Cooperative Agreement Z01-DA000499. K.L.Preston(*) . D. H. Epstein Treatment Section, Clinical Pharmacology and Therapeutics Branch, NIDA Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Room 01B-602, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, USA e-mail: kpreston@intra.nida.nih.gov
Funding Information:
Acknowledgments This research was supported by the Intramural Research Program (IRP) of the National Institute on Drug Abuse (NIDA), National Institutes of Health. We wish to thank the NIDA IRP Archway Clinic staff for data collection.
PY - 2011/11
Y1 - 2011/11
N2 - Rationale Quantitative real-time data on the stress experienced by drug misusers in their daily lives may provide additional insight into stress's role in drug use. Objective The purpose of this study is to evaluate stress in relation to craving, mood, relapse-trigger exposure, and cocaine use in cocaine-dependent outpatients. Methods Methadone-maintained cocaine- and heroinabusing outpatients (N=114) provided ecological momentary assessment data on handheld computers. Ratings of stress were compared to those of craving and mood and past-hour exposure to putative drug-use triggers in randomly prompted entries and in the 5 h prior to participantinitiated cocaine use reports. Results Stress had significant positive relationships with current ratings of craving for cocaine, heroin, and tobacco and with ratings of tiredness, boredom, and irritation, and had significant negative relationships with ratings of happiness and relaxation. Stress was significantly greater in entries in which participants also reported past-hour exposure to negative-mood triggers, most of the drugexposure triggers, or any trigger involving thoughts about drugs (e.g., tempted out of the blue). The linear increase in stress during the 5-h preceding individual episodes of cocaine use was not significant (p=0.12), though there was a trend for such an increase before the use episodes that participants attributed to stressful states when they occurred (p=0.87). Conclusions The findings suggest a complex role of stress in addiction. Stress reported in real time in the natural environment showed strong cross-sectional momentary relationships with craving, mood, and exposure to druguse trigger. However, the prospective association between stress ratings and cocaine-use episodes was, at best, weak.
AB - Rationale Quantitative real-time data on the stress experienced by drug misusers in their daily lives may provide additional insight into stress's role in drug use. Objective The purpose of this study is to evaluate stress in relation to craving, mood, relapse-trigger exposure, and cocaine use in cocaine-dependent outpatients. Methods Methadone-maintained cocaine- and heroinabusing outpatients (N=114) provided ecological momentary assessment data on handheld computers. Ratings of stress were compared to those of craving and mood and past-hour exposure to putative drug-use triggers in randomly prompted entries and in the 5 h prior to participantinitiated cocaine use reports. Results Stress had significant positive relationships with current ratings of craving for cocaine, heroin, and tobacco and with ratings of tiredness, boredom, and irritation, and had significant negative relationships with ratings of happiness and relaxation. Stress was significantly greater in entries in which participants also reported past-hour exposure to negative-mood triggers, most of the drugexposure triggers, or any trigger involving thoughts about drugs (e.g., tempted out of the blue). The linear increase in stress during the 5-h preceding individual episodes of cocaine use was not significant (p=0.12), though there was a trend for such an increase before the use episodes that participants attributed to stressful states when they occurred (p=0.87). Conclusions The findings suggest a complex role of stress in addiction. Stress reported in real time in the natural environment showed strong cross-sectional momentary relationships with craving, mood, and exposure to druguse trigger. However, the prospective association between stress ratings and cocaine-use episodes was, at best, weak.
KW - Addiction
KW - Cocaine
KW - Craving
KW - Ecological momentary assessment
KW - Human
KW - Stress
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U2 - 10.1007/s00213-011-2183-x
DO - 10.1007/s00213-011-2183-x
M3 - Article
C2 - 21336579
AN - SCOPUS:82955184637
SN - 0033-3158
VL - 218
SP - 29
EP - 37
JO - Psychopharmacology
JF - Psychopharmacology
IS - 1
ER -