Real-time assessment of alcohol drinking and drug use in opioid-dependent polydrug users

Abstract

We investigated relationships between drinking, other drug use, and drug craving, using ecological momentary assessment (EMA), in a sample of polydrug users who were not heavy drinkers. In a prospective longitudinal cohort study, 114 heroin and cocaine users in methadone-maintenance treatment carried handheld electronic diaries during waking hours and were screened for drug and alcohol use for up to 25 weeks. Individuals who met DSM criteria for alcohol abuse or dependence were excluded. Participants responded to 2–5 random prompts per day to report on their moods, cravings, and activities, and initiated entries when they used or acutely craved heroin or cocaine. Drinking alcohol was assessed in both types of entries. Breath alcohol was measured three times weekly. Participants reported drinking alcohol in 1.6% of random-prompt entries, 3.7% of event-contingent entries when craving cocaine and/or heroin, and 11.6% of event-contingent entries when using cocaine and/or heroin. Alcohol drinking was also associated with higher craving ratings and pre-study alcohol use. More drinking was detected by ambulatory self-report than by in-clinic breath testing. Even though we had screened out heavy drinkers from our sample of polydrug users, drinking was associated with heroin and cocaine craving and actual use.

One Is Not Enough: Understanding and Modeling Polysubstance Use

“…Some of the more commonly studied polydrug combinations include administration of cocaine with other drugs (Francesco et al, 2003;Leri et al, 2003b; Substance Abuse and Mental Health Services Administration, 2016). However, in contrast to human reports (Heil et al, 2001;Williamson et al, 2006;Staiger et al, 2013;Preston et al, 2016;Lorvick et al, 2018;Kariisa et al, 2019), an increase in addiction-like severity has not been observed in preclinical studies, suggesting a need for models with greater translational relevance that can capture the enhanced severity seen in human polysubstance users. Specifically, animal studies of sequential cocaine and alcohol or cocaine and heroin use have not found differences in drug intake or reinstatement of drug-seeking as a function of single versus polydrug use (Pattison et al, 2014;Fredriksson et al, 2017;Crummy et al, 2020;Stennett et al, 2020).…”

“…Polydrug use increases the risk of developing an alcohol use disorder (Grant et al, 2015(Grant et al, , 2016, particularly in young adults, men, and American Indians/Alaskan Natives (Falk et al, 2006). Polydrug use that includes alcohol is associated with additional comorbidities, including higher prevalence of mood disorders, anxiety disorders, more intense drinking, and more intense drug consumption and drug-craving (Preston et al, 2016;Saha et al, 2018). The negative consequences of alcohol polydrug use are also highlighted by data indicating that 21% of ED visits for patients 12-24 years old involved both alcohol and drugs.…”

Construction and Analysis of Protein-Protein Interaction Network of Heroin Use Disorder

“…In Taiwan, the frequency of cocaine use is low; however, the frequency of amphetamine use, a cocaine-like stimulant, is high in clients with HUD 57 . It might be due to most individuals with HUD abusing other substance such as amphetamine 58 , 59 .…”

High‐risk social drinkers and heavy drinkers display similar rates of alcohol consumption

“…Detailed characterization of drinking patterns in the field has been difficult in the past but may be facilitated by recent technological advances. For example, ecological momentary assessment has been used to provide temporal and geospatial profiles of drug and alcohol use . Such assessments should eventually be coupled with real‐time blood alcohol level measurement using wearable biosensors .…”