Daily cocaine craving in a 3-week inpatient treatment program

Abstract

Fifteen male veteran cocaine addicts took simple tests of cocaine craving, mood, energy, and perceived health status for 23 consecutive days during an inpatient treatment center. Results show they experienced very little cocaine craving or other symptomatology. Multiple regression analyses show that health rating alone was the best predictor of cocaine craving. These results question solely internal sources of craving and the oft‐touted craving‐depression connection. The study delineates further implications of the findings.

Money as a tool to extinguish conditioned responses to cocaine in addicts

“…We knew, from previous studies (Flowers et al, 1993;Voris et al, 1991), that patients recovering from cocaine addiction did not crave cocaine in the early phases of the 28 day inpatient program at this hospital. Common statements include, "I feel safe in here.…”

“…When used acutely, the intervention of handling cash and completion of the appropriate scale can induce strong craving, as evidenced in the present data. Thus, the handling of cash and use of the reliable, sensitive and replicable scales (Flowers et al, 1993;Voris, et al, 1991) may be useful in the testing of other interventions developed to reduce the craving for cocaine.…”

“…Responses were scored as the distance (to .1 cm) from the origin of each 20-cm scale to the subject's mark (Flowers et al, 1993), such that higher scores indicated "feeling well" (i.e., "no craving", "no irritability", "feel healthy" and "good self-esteem"), whereas lower scores indicated craving and other negative symptoms. Each subject's scores on each of the four scales, during each trial, were compiled and subjected to mixed-design analyses of variance using Groups as an independent factor and Trials as a repeated factor; scores on each scale (craving, irritability, health, and self-esteem) were analyzed separately.…”

“…Indeed, we and others have previously reported that cocaine addicts in an inpatient treatment program show little craving and, in fact, will make comments such as "I don't crave in here, but if I was on the street and saw a rock, I would be gone" (Flowers et al, 1993;Voris et al, 1991). Many patients also have stated to the authors that, after leaving treatment, cash money is one of the most powerful drug-associated stimuli that induces strong craving and an intense desire to use cocaine.…”

“…The purpose of this study was to quantify the effect of handling money to promote craving, irritability, and related aspects of self-reported well-being (Flowers et al, 1993;Voris et al, 1991) and to determine the efficacy of repeatedly presenting cash to inpatient cocaine addicts, in hopes of eventually extinguishing cash as a cue evoking drug craving.…”