Predictors of craving and substance use among patients with alcohol, tobacco, cannabis or opiate addictions: Commonalities and specificities across substances

Addict Behav. 2018 Aug:83:123-129. doi: 10.1016/j.addbeh.2018.01.041. Epub 2018 Feb 2.


Introduction: Craving has been proposed as a major contributor to addiction relapse and the influence of mood on craving and substance use has been extensively documented. However, information is lacking concerning the extent to which the magnitude of these effects may vary according to different types of substances. The aim of the present study was to compare the prospective links between emotions, craving and substance use in four groups of patients beginning treatment for alcohol, tobacco, cannabis, or opiate addiction.

Methods: Ecological Momentary Assessment (EMA) was used over a two-week period. Data were analyzed using hierarchical linear modeling (HLM).

Results: 159 participants were recruited (67.3% male; M = 36.7 years). The average response rate to the EMA assessments was 83.1%. The findings confirmed the strong predictive role of craving intensity on substance use reported at the next assessment of the day among the alcohol (γ = 0.224; p = .018), tobacco (γ = 0.133; p = .013) and cannabis groups (γ = 0.266; p = .019), but not for opiates (γ = 0.098; p = .142). Craving intensity was itself predicted by greater anxious mood (γ = 0.108; p = 0,029) and event negativity (γ = 0.107; p = .003) among tobacco patients, lower sad mood among cannabis patients (γ = -0.248; p = 0,002), and lower event negativity among opiate patients (γ = -0.201; p = .002).

Conclusion: While these results support the benefit of targeting craving in addiction treatment regardless of substance type, the substance-specific emotional risk factors for craving identified in this study may provide important insights for the development of personalized treatment strategies.

Keywords: Addiction; Craving; Ecological momentary assessment; Mood; Negative affect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect / physiology*
  • Alcohol-Related Disorders / physiopathology
  • Alcohol-Related Disorders / psychology
  • Behavior, Addictive / physiopathology*
  • Behavior, Addictive / psychology*
  • Craving / physiology*
  • Female
  • Humans
  • Male
  • Marijuana Abuse / physiopathology
  • Marijuana Abuse / psychology
  • Opioid-Related Disorders / physiopathology
  • Opioid-Related Disorders / psychology
  • Prospective Studies
  • Substance-Related Disorders / physiopathology*
  • Substance-Related Disorders / psychology*
  • Tobacco Use Disorder / physiopathology
  • Tobacco Use Disorder / psychology