Effects of length of abstinence on decision-making and craving in methamphetamine abusers

PLoS One. 2013 Jul 24;8(7):e68791. doi: 10.1371/journal.pone.0068791. Print 2013.


Rationale: The majority of drug abusers are incapable of sustaining abstinence over any length of time. Accumulating evidence has linked intense and involuntary craving, Impulsive decision-making and mood disturbances to risk for relapse. However, little is known about temporal changes of these neuropsychological functions in methamphetamine (METH)-dependent individuals.

Objectives: To investigate the effect of length of abstinence on decision-making, craving (baseline and cue-induced), and emotional state in METH-addicted individuals.

Methods: In this cross-sectional study, 183 adult METH-dependent patients at an addiction rehabilitation center who were abstinent for 6 days (n = 37), 14 days (n = 33), 1 month (n = 31), 3 months (n = 30), 6 months (n = 26), or 1 year (n = 30) and 39 healthy subjects were administered the Iowa Gambling Task (IGT) to assess decision-making performance. Depression, anxiety, and impulsivity were also examined. One hundred thirty-nine METH abusers who were abstinent for the aforementioned times then underwent a cue session, and subjective and physiological measures were assessed.

Results: METH dependent individuals who were abstinent for longer periods of time exhibited better decision-making than those who were abstinent for shorter periods of time. And self-reported emotional symptoms improved with abstinence. METH abusers' ratings of craving decreased with the duration of abstinence, while cue-induced craving increased until 3 months of abstinence and decreased at 6 months and 1 year of abstinence.

Conclusions: We present time-dependent alterations in decision-making, emotional state, and the incubation of cue-induced craving in METH-dependent individuals, which might have significant clinical implications for the prevention of relapse.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Behavior, Addictive / physiopathology*
  • Behavior, Addictive / psychology*
  • Cross-Sectional Studies
  • Cues
  • Decision Making / physiology*
  • Humans
  • Impulsive Behavior / physiopathology
  • Impulsive Behavior / psychology
  • Male
  • Methamphetamine / toxicity*
  • Time Factors


  • Methamphetamine

Grants and funding

This work was supported by the Natural Science Foundation of China (number 81000571), National Science foundation for Distinguished Young Scholars of China (number 81225009), National Basic Program of China (numbers 2009CB522000 and 91132719). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.