End-of-day reports of daily hassles and stress in men and women with opioid-use disorder: Relationship to momentary reports of opioid and cocaine use and stress

Abstract

Background and Aims: Stress can be validly assessed “live” or by a summary evaluation of the very recent past. Using smartphone-based ecological momentary assessment (EMA) combined with end-of-day (EOD) entries, we assessed the association between daily hassles, stressful events and use of opioids and cocaine, in opioid- and cocaine-using men and women Methods: For up to 16 weeks, 161 outpatients in opioid-agonist treatment who reported cigarette smoking carried smartphones on which they reported stressful events (SEs) and drug use (DU) and completed an EOD questionnaire to report hassles encountered throughout the day, current perceived stress, cigarettes/day, and current mood. We compared EOD responses on days with and without SE and DU reports and on days when thrice-weekly urine drug screens indicated opioid or cocaine use or abstinence. Results: Participants (N=161) made 11,544 EOD entries; EMA SEs were reported on 861 (7.5%) days, and DUs on 1685 (14.6%) days. The most frequently reported hassles in EOD entries were “not enough money” (31.4% of daily reports) and maintaining abstinence (18.7%). Total EOD hassles showed small but statistically significant associations [odds ratios (95% CIs)] with EMA SEs [1.09 (1.06–1.13)], DUs [1.08 (1.06–1.10)], and urine-positive opioid [1.06 (1.04–1.09)] and cocaine [1.03 (1.00–1.06)] results. Men and women had similar rates (mean/day (SD)) of hassles: men 2.25 (3.55); women 2.55 (3.76) (F1,159=0.53, p=0.47). Conclusions: Daily hassles, reported at the end of the day, are associated with both same-day stressful events and drug use. Monitoring hassles and devising specific coping strategies might be useful therapeutic targets.

Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research

“…Drug use.-Similar to craving, a concurrent positive association has been observed between stressful events and drug use, but this association shares the same concerns about temporal ordering (Neupert et al 2017, Preston et al 2018b. Consistent evidence for a prospective relationship has not yet been provided (Armeli et al 2007, Cronk & Piasecki 2010, Furnari et al 2015, Neupert et al 2017, Shiffman & Waters 2004.…”

Prediction of stress and drug craving ninety minutes in the future with passively collected GPS data

“…In each randomly prompted entry, participants rated their current heroin craving, cocaine craving, and stress. (Participants were also asked to initiate entries when they used drugs or experienced stressful events, 68 and prompted to make an entry at the end of each day, 69 but those data were not used in the present analyses). Participants carried the smartphones for up to 16 weeks and were paid $10-30 each week for completing at least 23 out of 28 weekly prompts.…”

Gender differences on methadone maintenance treatment outcome among patients with opioid use disorder: A systematic review

“…[ 25 26 ] However, methadone client rarely refused to terminate drug abuse unless they refused to have their methadone dose raised or if they refused to address chronic addiction to a secondary drug such as cocaine or alcohol. [ 27 28 ]…”