Weiss Roger D, Griffin Margaret L, Mazurick Carissa, Berkman Benjamin, Gastfriend David R, Frank Arlene, Barber Jacques P, Blaine Jack, Salloum Ihsan, Moras Karla
Department of Psychiatry, Harvard medical School, Boston, MA 02478, USA.
Am J Psychiatry. 2003 Jul;160(7):1320-5. doi: 10.1176/appi.ajp.160.7.1320.
Regular measurement of craving during treatment for cocaine dependence can monitor patients' clinical status and potentially assess their risk for drug use in the near future. Effective treatment can reduce the correlation between craving and subsequent drug use by helping patients abstain despite high craving. This study examined the relationship between cocaine craving, psychosocial treatment, and cocaine use in the ensuing week.
In the National Institute on Drug Abuse Collaborative Cocaine Treatment Study, which compared four psychosocial treatments for cocaine dependence, a three-item craving questionnaire was administered weekly to 449 patients to see whether it predicted cocaine use in the ensuing week. Cocaine use was assessed with self-reports and urine screening.
With control for the previous week's cocaine use, a higher composite score on the craving questionnaire was associated with greater likelihood of cocaine use in the subsequent week; each 1-point increase on the composite score of the craving questionnaire increased the likelihood of cocaine use in the ensuing week by 10%. However, among patients who received individual plus group drug counseling, the treatment condition with the best overall cocaine use outcome, increased craving scores were not associated with greater likelihood of cocaine use in the subsequent week.
A three-item cocaine craving questionnaire predicted the relative likelihood of cocaine use during the subsequent week. Moreover, the relationship between craving and subsequent cocaine use varied by treatment condition, suggesting that the most effective treatment in the study might have weakened the link between craving and subsequent use.
在可卡因依赖治疗期间定期测量渴求感能够监测患者的临床状态，并有可能评估他们在近期使用毒品的风险。有效的治疗可以通过帮助患者在渴求感强烈时仍保持戒断状态，来降低渴求感与后续毒品使用之间的相关性。本研究考察了可卡因渴求感、心理社会治疗与随后一周内可卡因使用之间的关系。
在国家药物滥用研究所可卡因治疗协作研究中，该研究比较了四种针对可卡因依赖的心理社会治疗方法，每周对449名患者进行一次包含三个条目的渴求感问卷调查，以观察其是否能预测随后一周内的可卡因使用情况。通过自我报告和尿液筛查来评估可卡因使用情况。
在控制了前一周的可卡因使用情况后，渴求感问卷上较高的综合得分与随后一周内使用可卡因的可能性更大相关；渴求感问卷综合得分每增加1分，随后一周内使用可卡因的可能性就增加10%。然而，在接受个体加团体药物咨询的患者中，这是总体可卡因使用结果最佳的治疗条件，渴求感得分增加与随后一周内使用可卡因的可能性增加无关。
一份包含三个条目的可卡因渴求感问卷能够预测随后一周内使用可卡因的相对可能性。此外，渴求感与随后可卡因使用之间的关系因治疗条件而异，这表明该研究中最有效的治疗方法可能削弱了渴求感与随后使用之间的联系。
