Journal articles: 'Alcohol craving'

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Olbrich, Hans M., Gabriele Valerius, Christine Paris, Friedemann Hagenbuch, Dieter Ebert, and Freimut D. Juengling. "Brain Activation During Craving for Alcohol Measured by Positron Emission Tomography." Australian & New Zealand Journal of Psychiatry 40, no. 2 (February 2006): 171–78. http://dx.doi.org/10.1080/j.1440-1614.2006.01765.x.

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Objective: Craving for alcohol is probably involved in acquisition and maintenance of alcohol dependence to a substantial degree. However, the brain substrates and mechanisms that underlie alcohol craving await more detailed elucidation. Method: Positron emission tomography was used to map regional cerebral blood flow (CBF) in 21 detoxified patients with alcohol dependence during exposure to alcoholic and non-alcoholic beverages. Results: During the alcohol condition compared with the control condition, significantly increased CBF was found in the ventral putamen. Additionally, activated areas included insula, dorsolateral prefrontal cortex and cerebellum. Cerebral blood flow increase in these regions was related to self-reports of craving assessed in the alcoholic patients. Conclusions: In this investigation, cue-induced alcohol craving was associated with activation of brain regions particularly involved in brain reward mechanisms, memory and attentional processes. These results are consistent with studies on craving for other addictive substances and may offer strategies for more elaborate studies on the neurobiology of addiction.

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Hernández-Serrano, Olga, Alexandra Ghiţă, Jolanda Fernández-Ruiz, Miquel Monràs, Antoni Gual, Mariano Gacto, Bruno Porras-García, Marta Ferrer-García, and José Gutiérrez-Maldonado. "Determinants of Cue-Elicited Alcohol Craving and Perceived Realism in Virtual Reality Environments among Patients with Alcohol Use Disorder." Journal of Clinical Medicine 10, no. 11 (May 21, 2021): 2241. http://dx.doi.org/10.3390/jcm10112241.

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The identification of variables that can modulate the efficacy of cue exposure using virtual reality (VR) is crucial. This study aimed to explore determinant variables of cue-elicited alcohol craving and perceived realism (PR) of environments and alcoholic beverages during a VR cue-exposure session among alcohol use disorder (AUD) outpatients. A prospective cohort study was conducted amongst 72 outpatients with AUD from a clinical setting. Alcohol craving experienced during VR exposure and PR of virtual environments and alcoholic drinks were evaluated after a VR session of exposure to alcohol-related contexts and cues. Sociodemographic, psychological and consumption characteristics were examined as possible predicting variables. Multiple linear regression analyses showed that the AUD severity and PR of beverages were predictors of cue-elicited alcohol craving. Educational level, PR of beverages and age were predictors of the PR of VR environments. In relation to the PR of VR beverages, cue-elicited alcohol craving and the PR of environments were predictors. A simple mediational model was also performed to analyze the influence of the PR of beverages on the relationship between the AUD severity and alcohol craving experienced during VR exposure: an indirect or mediational effect was found. PR of alcoholic beverages was (1) a key predictor of the PR of VR environments (and vice versa) and the alcohol craving (and vice versa) experienced during VR cue-exposure sessions using ALCO-VR software among AUD patients and (2) a mediator between AUD severity and cue-elicited alcohol craving.

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McNeill, Adam M., Rebecca L. Monk, Adam Qureshi, and Derek Heim. "Intoxication without anticipation: Disentangling pharmacological from expected effects of alcohol." Journal of Psychopharmacology 35, no. 11 (October 25, 2021): 1398–410. http://dx.doi.org/10.1177/02698811211050567.

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Background: The pharmacological effects of alcohol on executive function, craving and subsequent alcohol-seeking have been well documented. Yet, insufficient methodological controls within existing alcohol administration paradigms have meant that the relative importance of alcohol’s pharmacological and anticipatory effects remains in need of further elucidation. Aim: The objective of this study is to disentangle alcohol’s pharmacological effects from its anticipatory effects on alcohol-related cognitions and subsequent consumption. Methods: Inhibitory control, attentional bias and craving were assessed pre- and post-consumption in 100 participants who were randomly allocated to one of four beverage conditions in a two by two design: (1) alcohol aware (alcohol with participant knowledge (pharmacological/anticipation effects)), (2) alcohol blind (alcohol without participant knowledge; in a novel grain alcohol masking condition (pharmacological/no anticipation effects)), (3) placebo (no alcohol but participants were deceived (anticipation/non-pharmacological effects)) and (4) pure control (no alcohol with participant knowledge (no anticipation/non-pharmacological effects)). Results: Findings suggest that the pharmacological effects of alcohol result in greater inhibitory control impairments compared with anticipated effects. Anticipatory but not the pharmacological effects of alcohol were found to increase attentional bias. Both pharmacology and anticipation resulted in increased craving, though higher levels of craving were observed due to alcohol’s pharmacology. Furthermore, alcohol pharmacology resulted in heightened ad libitum consumption; however, anticipation did not. Changes in craving partially mediated the relationship between initial intoxication and subsequent drinking, while inhibitory control impairments did not. Conclusions: Successive alcohol consumption appears driven primarily by the pharmacological effects of alcohol which are exerted via changes in craving.

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Keyes, K. M., R. F. Krueger, B. F. Grant, and D. S. Hasin. "Alcohol craving and the dimensionality of alcohol disorders." Psychological Medicine 41, no. 3 (May 12, 2010): 629–40. http://dx.doi.org/10.1017/s003329171000053x.

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BackgroundICD-10 includes a craving criterion for alcohol dependence while DSM-IV does not. Little is known about whether craving fits with or improves the DSM-IV criteria set for alcohol-use disorders.MethodData were derived from current drinkers (n=18 352) in the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), a nationally representative survey of US adults >17 years of age. The Alcohol Use Disorder and Associated Disabilities Interview Schedule was used to assess the eleven DSM-IV dependence and abuse criteria, and alcohol craving. Exploratory factor, item response theory, and regression analyses were used to evaluate the psychometric properties and concurrent validity of DSM-based alcohol disorder criteria with the addition of alcohol craving.ResultsThe past 12-month prevalence of craving was 1.3%. Craving formed part of a unidimensional latent variable that included existing DSM-IV criteria. Craving demonstrated high severity on the alcohol-use disorder continuum, resulting in an improved dimensional model with greater discriminatory ability compared with current DSM-IV criteria. Correlates of the diagnosis did not change with the addition of craving, and past 12-month craving was associated with prior alcohol dependence, depression, and earlier age of alcohol disorder onset among those with current DSM-IV alcohol dependence.ConclusionsThe addition of craving to the existing DSM-IV criteria yields a continuous measure that better differentiates individuals with and without alcohol problems along the alcohol-use disorder continuum. Few individuals are newly diagnosed with alcohol dependence given the addition of craving, indicating construct validity but redundancy with existing criteria.

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Statham, Dixie J., Jason P. Connor, David J. Kavanagh, Gerald F. X. Feeney, Ross Mc D. Young, Jon May, and Jackie Andrade. "Measuring alcohol craving: development of the Alcohol Craving Experience questionnaire." Addiction 106, no. 7 (May 12, 2011): 1230–38. http://dx.doi.org/10.1111/j.1360-0443.2011.03442.x.

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TÜRKOĞLU, Sevgül, Sonia AMADO, Ali Saffet GÖNÜL, and Çağdaş EKER. "Comparison of Alcohol Attentional Bias and Alcohol Craving Among Alcohol Abusers and Non-Abusers." Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 14, Ek 1 (December 29, 2022): 75–82. http://dx.doi.org/10.18863/pgy.1095312.

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The aim of this research is to investigate implicit cognitive process underlying alcohol craving and relationship between alcohol attentional bias and alcohol craving by using visual probe task. Current study examined whether alcohol abusers show attentional bias toward alcohol related task compared with non- abusers and causal relationship between alcohol attentional bias and alcohol craving. Firstly, participants were divided two groups (non abusers- abusers) and they were completed alcohol craving scale to determinate their alcohol craving level. Then, participants alcohol attentional bias was investigated using the visual probe task. In this task, images (alcohol-related and neutral) were presented for 500 ms on a computer screen. After that, probe (*, asterisk) was presented. Participants were asked to decide the place of the probe place by using keyboard keys within 1500 ms. Participants reaction time and number of correct and incorrect answers during the test. According to results, alcohol abuser group’s reaction times were faster than non-abuser when probe was associated with alcohol picture but not in neutral trials. These results suggested that, alcohol abusers showed significantly greater attentional bias to alcohol related pictures than non- abusers. From this point, investigation of alcohol attentional bias might be important component of alcohol dependence in terms of the alcohol relapse risk and determination of the alcohol craving.

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He, Sean, Alyssa T. Brooks, Kyle M. Kampman, and Subhajit Chakravorty. "The Relationship between Alcohol Craving and Insomnia Symptoms in Alcohol-Dependent Individuals." Alcohol and Alcoholism 54, no. 3 (April 23, 2019): 287–94. http://dx.doi.org/10.1093/alcalc/agz029.

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AbstractAimThis preliminary investigation evaluated the link between alcohol craving and insomnia in actively drinking patients with alcohol dependence (AD).MethodsWe conducted a secondary analysis of data from a clinical trial of treatment-seeking patients with AD who drank heavily (N = 61). The Penn Alcohol Craving Scale (PACS) evaluated alcohol craving, and the Short Sleep Index (SSI) assessed insomnia symptoms. We used linear regression models for baseline cross-sectional assessments. Linear mixed effects regression models evaluated craving scores longitudinally across insomnia groups (+/−), and insomnia scores longitudinally across craving groups(high/low). These longitudinal analyses were conducted separately in those treated with placebo (N = 32) and quetiapine (N = 29).ResultsThe mean (standard deviation) for PACS total score was 15.9 (8.5) and for SSI was 2.1 (2.3). Alcohol craving was associated with the insomnia symptom of difficulty falling asleep (P = 0.03; effect size = −0.7) and with the SSI total score (P = 0.04, effect size = −0.7). In the longitudinal analysis, insomnia+ subjects had consistently higher PACS total scores, relative to the insomnia− group. The PACS score demonstrated significant group × time interactions in both treatment groups. Insomnia+ individuals demonstrated a relatively steeper rate of decline in the craving with quetiapine treatment (P = 0.03). Insomnia− individuals in the placebo group demonstrated a transient reduction in craving until week 8, followed by an increase in scores(P = 0.004). The SSI score did not demonstrate any interactive effect over time across the craving groups in either treatment arm.ConclusionInsomnia was associated with higher alcohol craving and quetiapine differentially reduced craving in those with insomnia.

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Czarnecki, Damian, Marcin Ziółkowski, Jan Chodkiewicz, Anna Długosz, Joanna Feldheim, Napoleon Waszkiewicz, Agnieszka Kułak-Bejda, et al. "Initial Study on COMT and DRD2 Gene Polymorphisms as Well as the Influence of Temperament and Character Trait on the Severity of Alcohol Craving in Alcohol-Dependent Patients." Journal of Clinical Medicine 10, no. 24 (December 15, 2021): 5892. http://dx.doi.org/10.3390/jcm10245892.

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The main aim of this work was to determine the impact of COMT and DRD2 gene polymorphisms together with temperament and character traits on alcohol craving severity alcohol-dependent persons. The sample comprised of 89 men and 16 women (aged 38±7). For the sake of psychological assessment various analytic methods have been applied like the Short Alcohol Dependence Data Questionnaire (SADD), Penn Alcohol Craving Scale (PACS) or Temperament and Character Inventory (TCI) test. The SNP polymorphism of the analyzed genes was determined by Real Time PCR test. The results showed, that the COMT polymorphismmay have an indirected relationship with the intensity and changes in alcohol craving during abstinence. The DRD2 receptor gene polymorphisms are related with the intensity of alcohol craving. It seems that the character traits like “self-targeting”, including “self-acceptance”, are more closely related to the severity of alcohol craving and polymorphic changes in the DRD2 receptor than temperamental traits. Although this is a pilot study the obtained results appeared to be promising and clearly indicate the link betweengene polymorphisms alcohol craving and its severity.

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Anton, Raymond F. "Alcohol Craving-A Renaissance." Alcoholism: Clinical and Experimental Research 23, no. 8 (August 1999): 1287–88. http://dx.doi.org/10.1111/j.1530-0277.1999.tb04348.x.

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Lesch, O. M., B. König, K. Ramskogler, A. Riegler, A. G. Zoghlami, and H. Walter. "S16.03 Craving for alcohol." European Psychiatry 15, S2 (October 2000): 240s—241s. http://dx.doi.org/10.1016/s0924-9338(00)94032-x.

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Kavanagh, David J., Dixie J. Statham, Gerald F. X. Feeney, Ross McD Young, Jon May, Jackie Andrade, and Jason P. Connor. "Measurement of alcohol craving." Addictive Behaviors 38, no. 2 (February 2013): 1572–84. http://dx.doi.org/10.1016/j.addbeh.2012.08.004.

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Hisler, G., S. Pedersen, D. Clark, S. Rothenberger, and B. Hasler. "0216 Is There a Daily Rhythm in Alcohol Craving and Does It Vary by Circadian Timing?" Sleep 43, Supplement_1 (April 2020): A84. http://dx.doi.org/10.1093/sleep/zsaa056.214.

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Abstract Introduction People with later circadian timing tend to consume more alcohol, potentially due to altered rhythms in when and how much they crave alcohol throughout the day. However, whether circadian factors play a role in alcohol craving has received scant attention. Here, we investigated if the daily rhythm of alcohol craving varied by circadian timing in two independent studies of late adolescent and young adult drinkers. Methods In Study 1, 32 participants (18–22 years of age; 61% female; 69% White) completed momentary reports of alcohol craving five times a day for 14 days. Participants wore wrist actigraphs and completed two in-lab assessments of dim light melatonin onset (DLMO). Average actigraphically-assessed midpoint of sleep on weekends and average DLMO were used as indicators of circadian timing. In Study 2, 231 participants (21–35 years of age; 28% female; 71% White) completed momentary reports of alcohol craving six times a day for 10 days. Average midpoint of self-reported time-in-bed on weekends was used to estimate circadian timing. Results Multilevel cosinor analysis revealed a 24-hour daily rhythm in alcohol craving which was moderated by circadian timing in both studies (p’s<0.05). In both Study 1 and 2, people with later circadian timing had a later timed peak of craving. In Study 1, but not Study 2, later circadian timing predicted a blunted amplitude in craving. Conclusion Findings support a daily rhythm in craving that varies by individual differences in circadian timing. Because craving is an important predictor of future alcohol use, the findings implicate circadian factors as a useful area to advance alcohol research and potentially improve interventions. Support R21AA023209; R01DA044143; K01AA021135; ABMRF/The Foundation for Alcohol Research.

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Rodrigues, Rui, Eduardo López-Caneda, Natália Almeida-Antunes, Adriana Sampaio, and Alberto Crego. "Portuguese validation of the Alcohol Craving Questionnaire–Short Form–Revised." PLOS ONE 16, no. 5 (May 24, 2021): e0251733. http://dx.doi.org/10.1371/journal.pone.0251733.

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Alcohol craving has been described as a strong subjective desire to drink, being considered highly valuable in the clinical practice, as it is recognized as a strong predictor of alcohol relapse in alcohol-dependent individuals. However, to date, there is not a multifactorial questionnaire available for assessing short-term acute craving experience in Portugal. The aim of the present study was to validate a swift and efficient tool for the assessment of acute alcohol craving in a sample of Portuguese citizens. For that purpose, the Alcohol Craving Questionnaire–Short Form–Revised (ACQ-SF-R) was translated into European Portuguese and administered to a sample of 591 college participants with ages between 18 and 30 years. Results suggested that a three-factor model (i.e., Emotionality, Purposefulness, and Compulsivity) proved to be most suitable for the Portuguese sample. Overall, the ACQ-SF-R exhibited good psychometric properties, having a good internal consistency both for the general craving index (Cronbach’s α = 0.85) and each subscale (Cronbach’s α = 0.66–0.83), as well as an appropriate convergent validity with the Penn Alcohol Craving Scale (r = 0.65, p<0.001), suggesting a good construct validity. In addition, the ACQ-SF-R also showed a good concurrent validity with the Alcohol Use Disorders Identification Test (r = 0.57, p<0.001), indicating that risky alcohol use patterns are associated with increased craving scores in the ACQ-SF-R. Collectively, these findings suggest that the Portuguese version of the ACQ-SF-R can accurately measure alcohol craving at a multifactorial level, being a valid and reliable tool to use in Portuguese samples in research settings.

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Cummings, Jenna R., Lara A. Ray, Peter Nooteboom, and A. Janet Tomiyama. "Acute Effect of Eating Sweets on Alcohol Cravings in a Sample with At-Risk Drinking." Annals of Behavioral Medicine 54, no. 2 (August 27, 2019): 132–38. http://dx.doi.org/10.1093/abm/kaz031.

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Abstract Background Alcohol craving, or the desire to drink alcohol, has been identified as a key experience preceding alcohol use. Alcoholics Anonymous has long claimed that individuals can allay alcohol cravings by eating sweets. Empirical tests of this strategy are limited to a few preclinical studies in rats, and there is no existing experiment testing the acute effect of eating sweets on alcohol cravings in humans. Purpose The current study sought to experimentally test the acute effect of eating sweets on alcohol cravings in a sample with at-risk drinking. Methods After being exposed to an alcohol cue, individuals with at-risk drinking (N = 150) were randomly assigned to eat sweets (n = 60), eat calorie-equivalent bland food (n = 60), or watch a video (n = 30). Caloric amounts were manipulated. Individuals with at-risk drinking were then exposed to a second alcohol cue. Changes in alcohol cravings from after the first to after the second alcohol cue were measured via visual analog scale and heart rate. Results There were no significant between-group differences in changes in alcohol cravings. Caloric amounts did not modify effects. Conclusions Experimental findings did not provide evidence to support the clinical lore that eating sweets can reduce alcohol cravings, albeit only acutely and for those with at-risk drinking. Other empirically supported strategies for managing alcohol cravings (e.g., pharmacotherapies, mindfulness) could instead be promoted.

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Hertling, Ines, Katrin Ramskogler, Alexander Dvorak, Anton Klingler, Gerda Saletu-Zyhlarz, Rudolf Schoberberger, Henriette Walter, Michael Kunze, and Otto Michael Lesch. "Craving and other characteristics of the comorbidity of alcohol and nicotine dependence." European Psychiatry 20, no. 5-6 (August 2005): 442–50. http://dx.doi.org/10.1016/j.eurpsy.2005.06.003.

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AbstractPurposeIn this cross-sectional study we compared alcohol-dependent smokers and non-alcohol-dependent smokers with respect to intensity of nicotine dependence, craving conditions, sleep disturbances, comorbidity with major depression, reasons for smoking, accompanying somatic diseases and patients' prolonged abstinence from smoking during the 3 years preceding the study.Subjects and methodsFifty-one alcohol-dependent smokers and 327 non-alcohol-dependent smokers diagnosed as ICD-10 and DSM-IV-nicotine dependent, were investigated by means of the Fagerström Test for Nicotine Dependence, the Lübeck Craving-Recurrence Risk Questionnaire and the Lesch Alcohol Dependence Typology (both adapted to smoking).ResultsThe intensity of nicotine dependence was more enhanced in alcohol-dependent smokers compared to non-alcohol-dependent smokers. Several variables of all factors of craving (“depressive mood”, “stimulation”, “relaxation”, “socially triggered tension”) were significantly increased in alcohol-dependent patients (P < 0.05). Alcohol-dependent smokers showed depressive symptoms and sleep disturbances, whilst non-alcohol-dependent individuals mainly smoked for stress release and weight control.DiscussionOur study demonstrates that the intensity of nicotine dependence, several conditions of craving for nicotine, sleep disturbances and symptoms of depression appear to be enhanced in alcohol-dependent smokers compared with non-alcohol-dependent smokers.ConclusionsIt is hoped that the factors of craving and reasons for smoking identified in this study will contribute to a better understanding of smoking temptation in alcohol-dependent smokers and non-alcohol-dependent smokers in future.

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Belgers, Maarten, Philip Van Eijndhoven, Wiebren Markus, Aart Schene, and Arnt Schellekens. "rTMS Reduces Craving and Alcohol Use in Patients with Alcohol Use Disorder: Results of a Randomized, Sham-Controlled Clinical Trial." Journal of Clinical Medicine 11, no. 4 (February 11, 2022): 951. http://dx.doi.org/10.3390/jcm11040951.

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(1) Background: Current evidence-based treatments for alcohol use disorder (AUD) are moderately effective. Studies testing repetitive transcranial magnetic stimulation (rTMS) in AUD commonly apply a limited number of rTMS sessions with different rTMS settings, showing inconsistent effects on craving for alcohol. This study tested the efficacy of a robust rTMS protocol on craving and alcohol use. (2) Methods: In a single-blind randomized controlled trial in recently detoxified patients with AUD, ten days of high-frequency rTMS over the right dorsolateral prefrontal cortex on top of treatment as usual (n = 14) was compared with sham rTMS (n = 16). Outcome measures were alcohol craving and use over a follow-up period of one year. Analysis was performed by means of repeated measures multivariate analysis of variance. (3) Results: The results showed a main group-by-time interaction effect on craving (Wilks’ Λ = 0.348, F (12, 17) = 2.654, p = 0.032) and an effect of group on alcohol use (Wilk’s Λ = 0.44, F (6, 23) = 4.9, p = 0.002), with lower alcohol craving and use in the group with active rTMS compared to the control group. Differences in craving between groups were most prominent three months after treatment. At 12 months follow-up, there was no effect of rTMS on craving or abstinence. (4) Conclusions: This small-scale randomized controlled trial showed the efficacy of high-frequency rTMS over the right dlPFC diminished alcohol craving and use in recently detoxified patients with AUD during the first months after detoxification. These findings suggest that rTMS might be an effective add-on in treating patients with AUD and warrant replication in future large-scale studies.

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Hernández-Serrano, Olga, Alexandra Ghiţă, Natàlia Figueras-Puigderrajols, Jolanda Fernández-Ruiz, Miquel Monras, Lluïsa Ortega, Silvia Mondon, et al. "Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder." Journal of Clinical Medicine 9, no. 9 (September 18, 2020): 3018. http://dx.doi.org/10.3390/jcm9093018.

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Background/Objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ2 = 13.818; p = 0.003) but not within the TAU group (χ2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.

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Ghiţă, Alexandra, Olga Hernández-Serrano, Yolanda Fernández-Ruiz, Miquel Monras, Lluisa Ortega, Silvia Mondon, Lidia Teixidor, et al. "Cue-Elicited Anxiety and Alcohol Craving as Indicators of the Validity of ALCO-VR Software: A Virtual Reality Study." Journal of Clinical Medicine 8, no. 8 (August 2, 2019): 1153. http://dx.doi.org/10.3390/jcm8081153.

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Background: This study is part of a larger project aiming to develop a virtual reality (VR) software to be implemented as a clinical tool for patients diagnosed with alcohol use disorder (AUD). The study is based on previous research in which we identified factors that elicit craving for alcohol in a sample of AUD patients, and which led to the development of a virtual reality software to be used in cue exposure treatments of alcohol use disorder (ALCO-VR). The main objective of this study was to test the effectiveness of ALCO-VR to elicit cue-induced craving and anxiety responses among social drinkers (SD) and AUD patients. Our secondary objective was to explore which responses (cue-induced craving or anxiety) can best differentiate between AUD patients and the SD group. Method: Twenty-seven individuals (13 AUD patients and 14 SD) participated in this study after giving written informed consent. Their anxiety and alcohol craving levels were measured by different instruments at different stages of the procedure. The VR equipment consisted of Oculus Rift technology, and the software consisted of the ALCO-VR platform. Results: Our data indicate that the ALCO-VR software can elicit responses of anxiety and alcohol craving, especially in the group of AUD patients. The cue-induced anxiety response differentiated AUD patients and the SD group better than the cue-induced craving response. Conclusions: The general interest in applying new technologies to the assessment and treatment of mental health disorders has led to the development of immersive real-life simulations based on the advantages of VR technology. Our study concluded that the ALCO-VR software can elicit anxiety and craving responses and that cue-induced anxiety responses can distinguish between AUD and SD groups better than cue-induced craving. The data on craving and anxiety were assessed consistently by different instruments. In addition, we consider that ALCO-VR is able to ecologically assess cue-induced anxiety and alcohol craving levels during exposure to VR alcohol-related environments.

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Stepanova, Elena V., David J. Echevarria, Adam D. Collier, Cristobal S. Cruz, Nafiyah Kirkland, and David J. Drobes. "Discrimination, Stress and Reactivity to Alcohol Cues." Journal of Social and Clinical Psychology 38, no. 10 (December 2019): 836–59. http://dx.doi.org/10.1521/jscp.2019.38.10.836.

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Introduction: Our study investigated whether discrimination affects psychologi-cal/physiological stress and alcohol craving. Method: Participants (N = 92) were asked to recall and write about (a) a neutral, (b) a negative, or (c) a discriminatory experience in the past and then completed a cue-reactivity procedure assessing their alcohol craving. In addition, we assessed levels of perceived stress before and after the discrimination manipulation, chronic substance use and craving, prior perceived discrimination, and strength of racial/ethnic identity. Results: Results revealed a small effect in which the discrimination condition increased alcohol cue-elicited craving relative to the other conditions. Chronic craving moderated effects of discrimination on cortisol levels. Self-reported stress levels were increased in the discrimination and negative memory conditions relative to baseline. Strength of racial identity served as a protective factor for substance abuse in those who reported chronic high levels of discrimination. Discussion: We discussed the direct link established between acute exposure to discrimination and craving, and experimental evidence for the relationship between discrimination and self-reported stress, but also addressed potential limitations of this work. It is further discussed how some individual differences factors (e.g., chronic craving) predict physiological stress in discriminatory settings. This work underscored the role of racial identity as a protective factor against alcohol abuse in individuals reporting high levels of discrimination.

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Mehta, S., A. Baruah, D. Chetia, S. Das, and P. Avinash. "Leptin and ghrelin levels in alcohol-dependent patients and their relationship with withdrawal and craving." European Psychiatry 41, S1 (April 2017): S392. http://dx.doi.org/10.1016/j.eurpsy.2017.02.443.

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IntroductionAssociation between leptin and ghrelin plasma levels and alcohol craving have been found in few studies but they have failed to differentiate this correlation with alcohol withdrawal state.ObjectivesTo research this correlation in a different population and to study this correlation with respect to hyper-excitable state of alcohol withdrawal.AimTo study levels of leptin and ghrelin in relation with alcohol withdrawal and craving.MethodsTwenty-five indoor patients fulfilling the alcohol dependence criteria were assessed for alcohol withdrawal symptoms and craving. Leptin and ghrelin levels were measured on 1st day, @ the end of 1st week, @ the end of 3rd week of stopping alcohol. Withdrawal was assessed using CIWA-A at day 1 and day 7, craving was assessed using PENN's scale of craving at the end of week 1 and week 3. Control group consisted of 15 first-degree relatives not taking alcohol.ResultsIt was found that leptin [t (38) = 2.95, P = 0.005] and ghrelin [t (38) = 2.56, P = 0.015] were significantly higher in alcohol-dependent patients. Levels of hormones had no significant correlation with alcohol withdrawal scores but had positive correlation with craving scores after abstinence.ConclusionsLeptin and ghrelin, known for balancing the energy homeostasis of body, also seem to play a role in pathways of drug dependence and craving. This relation is independent of stress hormone axis as leptin and ghrelin levels are not correlated with withdrawal scores, which is an indicator of stress hormone axis activation during alcohol withdrawal.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Karl, Damian, J. Malte Bumb, Patrick Bach, Christina Dinter, Anne Koopmann, Derik Hermann, Karl Mann, Falk Kiefer, and Sabine Vollstädt-Klein. "Nalmefene attenuates neural alcohol cue-reactivity in the ventral striatum and subjective alcohol craving in patients with alcohol use disorder." Psychopharmacology 238, no. 8 (April 12, 2021): 2179–89. http://dx.doi.org/10.1007/s00213-021-05842-7.

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Abstract Rationale Alcohol use disorder is a common and devastating mental illness for which satisfactory treatments are still lacking. Nalmefene, as an opioid receptor modulator, could pharmacologically support the reduction of drinking by reducing the (anticipated) rewarding effects of alcohol and expanding the range of treatment options. It has been hypothesized that nalmefene acts via an indirect modulation of the mesolimbic reward system. So far, only a few imaging findings on the neuronal response to nalmefene are available. Objectives We tested the effect of a single dose of 18 mg nalmefene on neuronal cue-reactivity in the ventral and dorsal striatum and subjective craving. Methods Eighteen non-treatment-seeking participants with alcohol use disorder (67% male, M = 50.3 ± 13.9 years) with a current high-risk drinking level (M = 76.9 ± 52 g of pure alcohol per day) were investigated using a cue-reactivity task during functional magnetic resonance imaging (fMRI) in a double-blind, placebo-controlled, cross-over study/design. In addition, self-reported craving was assessed before and after exposure to alcohol cues. Results An a priori defined region of interest (ROI) analysis of fMRI data from 15 participants revealed that nalmefene reduced alcohol cue-reactivity in the ventral, but not the dorsal striatum. Additionally, the subjective craving was significantly reduced after the cue-reactivity task under nalmefene compared to placebo. Conclusion In the present study, reduced craving and cue-reactivity to alcohol stimuli in the ventral striatum by nalmefene indicates a potential anti-craving effect of this drug via attenuation of neural alcohol cue-reactivity.

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Altshuler, Y., S. Kravchenko, and N. Cherednitchenko. "Pharmacotherapy of Craving for Alcohol." European Psychiatry 12, S2 (1997): 206s. http://dx.doi.org/10.1016/s0924-9338(97)80635-9.

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Bille, A., C. Bregengård, S. E. Møller, and J. Andersen. "Alcohol craving treated with fluvoxamin." European Neuropsychopharmacology 1, no. 3 (September 1991): 450. http://dx.doi.org/10.1016/0924-977x(91)90662-e.

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Iwanicka, Katarzyna, and Marcin Olajossy. "The concept of alcohol craving." Psychiatria Polska 49 (2015): 295–304. http://dx.doi.org/10.12740/pp/27538.

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Ludwig, Arnold M. "Pavlov's “bells” and alcohol craving." Addictive Behaviors 11, no. 2 (January 1986): 87–91. http://dx.doi.org/10.1016/0306-4603(86)90032-8.

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Sánchez, Edén, Carlos S. Cruz Fuentes, Corina Benjet, and María Elena Medina-Mora. "Impaired control in heavy drinking and its association with alcohol craving and alcohol use disorder severity." Salud mental 43, no. 4 (July 28, 2020): 151–57. http://dx.doi.org/10.17711/sm.0185-3325.2020.021.

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Introduction. Impaired control over drinking has been frequently cited in diverse theoretical descriptions regarding harmful alcohol use and is considered a DSM criterion for alcohol use disorder. Differences in the frequency of endorsement of impaired control have been viewed as a reflection of the severity of the problem. Moreover, it has been posited that the ability to place a limit on alcohol consumption may be mediated through enhanced craving. Objective. In this study, we addressed the relationship between impaired control, self-reported craving, and alcohol dependence severity among heavy drinkers. Method. We conducted a latent class analysis of impaired control dimensions (perceived control, failed control, and attempted control) of 208 heavy drinkers. To determine whether the identified classes could represent different forms of severity of the disorder, the best-fit model was contrasted with scores on the Alcohol Dependence Scale. Furthermore, we assessed the relationship between impaired control criteria (using the Impaired Control Scale [ICS]) with alcohol craving. Results. We identified a three-class solution based on impaired control severity. A graded increase of the craving scores and alcohol severity among the three classes was also identified. Only the ICS items comprising perceived control and partially those related to failed control, but not those evaluating attempted control, distinguished the gradient among the latent classes. Discussion and conclusion. This study provides further support of the proposal of a unidimensional continuum of severity among heavy drinkers and strengthens the theoretical relationship between impaired control and alcohol craving.

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Constant, Aymery, Marlène Sanz, and Romain Moirand. "Predictors of Short-Term Alcohol Drinking in Patients with Alcohol Use Disorders during the Third Wave of the COVID-19 Pandemic: Prospective Study in Three Addiction Outpatient Centers in France." International Journal of Environmental Research and Public Health 19, no. 4 (February 10, 2022): 1948. http://dx.doi.org/10.3390/ijerph19041948.

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The present study investigates the extent to which the COVID-19 crisis disturbed different life domains of patients with alcohol use disorder (AUD) and assessed the associations between these disturbances and the risk of short-term alcohol drinking. All patients aged >18 years receiving outpatient care at three addiction treatment facilities from 15 April to 30 May 2021 were eligible for inclusion in the study. A trained resident assessed the extent to which the COVID-19 crisis affected their professional activity, social life, access to healthcare, and drinking problems, together with craving, drinking behavior, psychological distress, physical/mental health, and sociodemographic and clinical data. The same investigator assessed alcohol drinking 1 month after their visit. Nearly half of the patients felt that the COVID-19 crisis had a serious impact on their drinking problems, despite minor disruptions in access to healthcare. These disturbances significantly influenced short-term alcohol drinking in univariate analysis, together with psychological distress, craving, and drinking problems. Only craving predicted alcohol drinking in multivariate analyses, suggesting that psychological and drinking problems, as well as COVID-19 disturbances, increased the risk of alcohol drinking by increasing craving. Craving should be systematically investigated in patients with AUD to establish adapted social support systems during pandemics.

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GRÜSSER, SABINE M., CHANTAL P. MÖRSEN, and HERTA FLOR. "ALCOHOL CRAVING IN PROBLEM AND OCCASIONAL ALCOHOL DRINKERS." Alcohol and Alcoholism 41, no. 4 (April 24, 2006): 421–25. http://dx.doi.org/10.1093/alcalc/agl035.

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Sosin, I., G. Mysko, O. Sergienko, O. Honcharova, Y. Babenko, and O. Minko. "Method of relieving alcohol dysphoria in the structure of hypertoxic alcohol abuse state with compulsive craving manifestations." European Psychiatry 64, S1 (April 2021): S562—S563. http://dx.doi.org/10.1192/j.eurpsy.2021.1499.

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IntroductionAlcohol dysphoria is a pathognomonic, severe, and therapeutically resistant syndrome considerable for alcohol and drug-addicted patients. The term “dysphoria” (from Greek δυσφορέω to suffer, torment, annoy) means an abnormally low type of mood, characterized by anger, gloom, irritability, feelings of hostility to others. In addictology, it is often identified in the withdrawal syndrome structure.ObjectivesTo develop innovative improvement in treatment for alcohol dysphoria.MethodsValid clinical diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing), statistical methods identifying alcohol dependence complicated by dysphoria.ResultsThe proposed method involves a complex of anti-affective, anti-abstinence, anti-craving pharmacological agents and drug-free methods, and differs from those conventional, along with psychotherapeutic potentiation, by additional targeted pharmacological triad (peroral Carbamazepine 200 mg twice a day: in the morning and in the evening; intramuscular Halopril (Haloperidol) 1 ml (5 mg) daily; oral Sonapax 1 tablet (25 mg) three times a day for 3-5 day treatment) used for a new purpose. 17 patients experienced this method. Efficacy: alcohol dysphoria acute manifestations were relieved by our method within 3-5 days that 37.8% exceeds conventional treatment. In 15 minutes, patients decreased irritability, motor restlessness, stress, cravings for alcohol. In 30 minutes, the patients fell asleep. Sleep lasted 3.5 hours on average. Subsequently, patients denied craving for alcohol, calmed down emotionally and psychomotorically, wished to be treated for alcoholism. No dysphoric relapses were observed.ConclusionsThe proposed multimodality method alleviates alcohol-induced dysphoria, involving pharmacotherapeutic triad along with psychotherapeutic potentiation.

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Brown, Darin R., Trevor C. J. Jackson, Eric D. Claus, Victoria R. Votaw, Elena R. Stein, Charles S. H. Robinson, Adam D. Wilson, et al. "Decreases in the Late Positive Potential to Alcohol Images Among Alcohol Treatment Seekers Following Mindfulness-Based Relapse Prevention." Alcohol and Alcoholism 55, no. 1 (December 11, 2019): 78–85. http://dx.doi.org/10.1093/alcalc/agz096.

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Abstract Aim Heightened craving among individuals with alcohol use disorder (AUD) has been attributed to a hypersensitivity to alcohol cues in attentional brain networks. Active mindfulness training has been shown to help improve attentional control. Here, we examined alcohol cue-related hypersensitivity among individuals with AUD who received rolling group mindfulness-based relapse prevention (MBRP) in combination with transcranial direct current stimulation (tDCS), over right inferior frontal gyrus. Methods Participants (n = 68) viewed a series of emotionally negative, emotionally neutral and alcohol-related images. Following image presentation, participants were asked to rate their level of craving for the alcohol cues, and their level of negative affect evoked by neutral and negative cues. During the task, electroencephalogram (EEG) was recorded to capture an event-related component shown to relate to emotionally salient stimuli: the late positive potential (LPP). Participants who completed a follow-up EEG (n = 37) performed the task a second time after up to eight sessions of MBRP coupled with active or sham tDCS. Results We found that both craving ratings and the LPP significantly decreased in response to alcohol cues from pre- to post-treatment, but not for other image cues. The magnitude of alcohol image craving reductions was associated with the number of MBRP group sessions attended. Active tDCS was not associated with craving ratings, but it was associated with greater LPP amplitudes across image types. Conclusions Taken together, these results suggest that disruption of alcohol-cue hypersensitivity in people with AUD may be a target mechanism of MBRP.

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Wetherill, Reagan R., Nathaniel Spilka, Kanchana Jagannathan, Paige Morris, Danielle Romer, Timothy Pond, Kevin G. Lynch, Teresa R. Franklin, and Henry R. Kranzler. "Effects of topiramate on neural responses to alcohol cues in treatment-seeking individuals with alcohol use disorder: preliminary findings from a randomized, placebo-controlled trial." Neuropsychopharmacology 46, no. 8 (February 8, 2021): 1414–20. http://dx.doi.org/10.1038/s41386-021-00968-w.

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AbstractTopiramate, a GABA/glutamate modulator, is efficacious in reducing alcohol consumption, though the mechanisms underlying this effect are not well characterized. This study analyzed functional magnetic resonance imaging (fMRI) data from 22 heavy drinkers enrolled in a 12-week placebo-controlled, randomized clinical trial of topiramate to examine the effects of topiramate on alcohol cue-elicited brain responses, craving, and heavy drinking in individuals with DSM-5 alcohol use disorder. Patients were randomized to receive either topiramate (maximal daily dosage of 200 mg/day) or placebo and were administered an fMRI alcohol cue-reactivity task at baseline (before starting medication) and after 6 weeks of double-blind treatment. Analyses compared the topiramate (n = 12) and placebo (n = 8) groups on (1) the change in brain responses during alcohol cue exposure (vs non-alcohol cues) within five a priori regions of interest related to reward—the bilateral and medial orbitofrontal cortex (OFC) and bilateral ventral striatum (VS) and (2) change in craving and heavy drinking days (HDDs) from baseline and scan 2. Topiramate, relative to placebo, reduced alcohol cue-elicited activation of the left VS, bilateral OFC, and medial OFC, alcohol cue-elicited craving, and HDDs between baseline and 6 weeks of treatment. The reduction in alcohol cue-elicited activation in the medial OFC correlated with reductions in craving, and reduced activation in the right VS, right OFC, and medial OFC correlated with the reduction in HDD. This preliminary study provides evidence that topiramate’s attenuation of alcohol cue-elicited brain activation and craving are key elements of the drug’s neurobiological mechanism of action in reducing heavy drinking.

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Villarreal-Mata, Julia Lizeth, Martín Sánchez-Gómez, Edna Idalia Paulina Navarro-Oliva, María Magdalena Alonso Castillo, Francisco Rafael Guzmán Facundo, Karla Selene López García, and Edgar Bresó Esteve. "Inteligencia emocional como mediador del craving y el riesgo de recaída en adultos en tratamiento por consumo de alcohol." Salud Uninorte 38, no. 03 (December 5, 2022): 729–41. http://dx.doi.org/10.14482/sun.38.3.152.4.

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Objetivos: analizar el efecto de craving sobre el riesgo de recaída en adultos en tratamiento por alcohol, considerando la Inteligencia Emocional Percibida (IEP) como mediador. Materiales y métodos: estudio descriptivo, transversal, predictivo, de comprobación de modelo con análisis de mediación. La muestra fue de 274 adultos internos en Centros de Rehabilitación contra las Adicciones (CRCA). Los instrumentos utilizados fueron una Cédula de Datos Sociodemográficos, Cuestionario de Craving por Alcohol, Inventario de Cociente Emocional y Cuestionario de Variables Predictoras de Abandono y Adhesión al Tratamiento. Resultados: existe una relación inversa entre la IEP, el riesgo de recaída (r = -,381, p <.001) y el craving (r = -,354, p <.001). El craving y el riesgo de recaída se relacionaron positivamente (r = ,218, p <.001). Se reporta un efecto total significativo del craving sobre el riesgo de recaída cuando es mediado por la IE el cual explica el 11% de la varianza (B= ,1389; t = ,5,688; p <,001). Conclusiones: los resultados de este estudio indican que IEP se asocia inversamente con el craving y el riesgo de recaída, además de que la IEP desempeña un papel significativo como mediador en esta relación. Esto sugiere que las personas con altos niveles de IEP disponen de más recursos para gestionar sus emociones, lo que podría ayudar a reducir las conductas de craving y consecuentemente, sufrir un menor riesgo de recaída en el consumo de alcohol.

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Goodyear, Kimberly. "Multisensory Environments to Measure Craving During Functional Magnetic Resonance Imaging." Alcohol and Alcoholism 54, no. 3 (March 28, 2019): 193–95. http://dx.doi.org/10.1093/alcalc/agz021.

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Abstract There are limited functional magnetic resonance imaging (fMRI) studies that measure alcohol craving with multisensory environments. Researchers are faced with a two-fold challenge: to recreate a naturalistic environment during an MRI scan and to produce paradigms that mimic real-life conditions involved with craving. Craving is a multifaceted psychological construct and techniques such as fMRI provide an alternative way to measure craving and to have a better understanding of its complexity. Most studies to date have implemented visual stimuli to measure craving and only a few studies have investigated gustation and olfaction. Moving forward, there needs to be greater attention on the ways in which we measure craving and the use of multisensory environments during fMRI. By going beyond examining subjective craving responses, and investigating neurobiological responses such as brain activity during fMRI, can potentially lead to better treatments for alcohol use disorder. Further, there needs to be additional consideration on standardizing how we measure craving, which will allow for a more unified approach amongst researchers.

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Skvira, I. M. "The Clinical Structure of Remission from Alcohol Dependence." Health and Ecology Issues, no. 3 (September 28, 2019): 17–24. http://dx.doi.org/10.51523/2708-6011.2019-16-3-3.

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The review presents the clinical factors of destabilization of remission and relapse in alcohol dependence. Traditionally, among these factors the leading role belongs to the pathological craving for alcohol. However, the craving for alcohol is a rare phenomenon in remission from alcohol dependence and even if expressed significantly it does not always become a predictive factor for relapse. Currently, there are many other clinical relapse-dangerous factors which must be taken into account in the treatment and rehabilitation of alcohol-dependent individuals.

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Haeny, Angela M., Meghan Morean, Kelly S. DeMartini, Melissa Funaro, and Stephanie S. O’Malley. "73936 Developing a Patient-Rated Outcome Measure of Alcohol and Drug Craving: A Systematic Review." Journal of Clinical and Translational Science 5, s1 (March 2021): 39. http://dx.doi.org/10.1017/cts.2021.505.

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ABSTRACT IMPACT: The findings from this study will inform the development of an FDA-approved patient-rated outcome measure of drug and alcohol craving that can be used in clinical trials aimed at developing or testing effective treatments for substance use disorder. OBJECTIVES/GOALS: Craving is a potential target of investigative medications to reduce drug use due to the strong link between craving and drug use. We will identify all existing craving measures as the first step for developing an FDA-approved patient-rated outcome measure for use in clinical trials. METHODS/STUDY POPULATION: Following PRISMA guidelines, we will update Rosenberg’s (2009) craving review by conducting a systematic review of all existing published and unpublished measures of craving for alcohol, nicotine, cannabis, opioid, and stimulant use. Electronic database (i.e., Ovid MEDLINE, Embase, PsycINFO, Web of Science, Cochrane), forward, backward, and author searches will be conducted. We will also request unpublished craving measures on major listservs (e.g., Research Society on Alcoholism, the Collaborative Perspectives on Addiction, and the College on Problems of Drug Dependence). All papers included in Rosenberg’s (2009) review through September 2020 will be included. RESULTS/ANTICIPATED RESULTS: The findings from this review will provide a comprehensive summary of the construct of craving and its hypothesized and tested domains. This review will elucidate whether the literature suggests there are components of craving unique to alcohol, nicotine, cannabis, opioid, and/or stimulant use, and whether there are key elements of craving common across the disorders. Therefore, these findings will inform whether a single patient-rated outcome measure of craving can be developed for use across substances or if unique patient-rated outcome measures of craving need to be developed for each substance. DISCUSSION/SIGNIFICANCE OF FINDINGS: While many different measures of craving exist, none have gone through the developmental steps required to qualify as an FDA-approved patient-rated outcome measure on which drug treatment labeling can be based. Completing this systematic review is the first step in this process.

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Rudio, G. "Role of inhibitory processes in relapse prevention treatment." European Psychiatry 33, S1 (March 2016): S44. http://dx.doi.org/10.1016/j.eurpsy.2016.01.899.

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Alcohol dependence is a chronic disorder with frequent relapses during recovery. Most studies have pointed out that craving is the main process involved in relapse, but recently other factors have been implicated in it, such as attentional bias and impulsivity. Some authors consider that different stages could be involved in the relapse process, and each may be governed by different mechanisms: Attentional bias; motivational response to alcohol cues and inhibitory control.Motivationally salient cues attract and hold selective attention, and this “attentional bias, (AB)” is related to individual differences in appetitive and aversive motivation. In a recent review, attentional bias has been shown to be significantly present in alcohol-dependent and is associated with craving and risk to a relapse in alcohol consumption.In alcohol-dependent subjects, alcohol-related cues reach a very high motivational valence (Motivational response, MR), which, in effect, increases craving for alcohol and activates behavioral strategies towards alcohol intake. One method used to assess motivational valence of alcohol is the craving self-assessment. In addition, in recent years, the affective modulation of the startle reflex has been used as an objective measure of craving. It has been shown that subjects with a low baseline startle response when viewing alcohol-associated pictures are at major risk of relapse compared to those with increased reactions.Once alcohol craving has appeared, the subject will either drink or not, depending on his ability to resist his behavior towards alcohol consumption (impulsivity or inhibitory control, IC). Moreover, subjects that exhibit greater impulsivity are those more likely to relapse.Our group has recently conducted a study on a sample of 172 alcohol-dependent patients seen in outpatient therapeutic program during 12 weeks. All of them were assessed with the following measures: Attentional bias was assessed using the dot task, motivational response was evaluated using the affective modulation of the startle reflex paradigm, inhibitory control was assessed by the stop-signal reaction time task. Alcohol relapse variables were: relapse, days to the first relapse and days of accumulated abstinence.One of the most relevant results was that processes related to inhibitory control (Stop-signal reaction time and attentional bias) were the most relevant measures to explain variables related to relapse in alcohol consumption during the treatment period.Our results support the use of assessment strategies, therapeutic and pharmacological inhibtoria aimed at improving the ability of serious alcohol-dependent patients.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Schuster, Rilana, Matthias Winkler, Anne Koopmann, Patrick Bach, Sabine Hoffmann, Iris Reinhard, Rainer Spanagel, J. Malte Bumb, Wolfgang H. Sommer, and Falk Kiefer. "Calcium Carbonate Attenuates Withdrawal and Reduces Craving: A Randomized Controlled Trial in Alcohol-Dependent Patients." European Addiction Research 27, no. 5 (2021): 332–40. http://dx.doi.org/10.1159/000512763.

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Introduction: Preclinical studies have shown that calcium seems to be the active component of the anti-craving drug acamprosate (Ca2+ bis-acetyl-homotaurinate). Clinical effects in humans have also indicated an association between increased calcium plasma concentration due to acamprosate treatment and better outcome relating to time to relapse and cumulative abstinence. In contrast, low calcium concentration in alcohol-dependent patients was related with craving for alcohol. The main goal of the trial was to investigate whether an oral calcium administration is able to affect craving, withdrawal, and relapse risk in alcohol-dependent patients. Methods: We conducted a single-blind, randomized, monocentric, controlled clinical two-arm trial in alcohol-dependent patients (Clinical Trials Registration: DRKS00011293). A total of 55 alcohol-dependent subjects received calcium carbonate (800 mg + 5 μg vitamin D) versus sodium bicarbonate (1,000 mg) daily during the 14 days of inpatient alcohol-withdrawal treatment. Results: Based on an intention-to-treat protocol, withdrawal intensity (assessed with CIWA-Ar) in the calcium carbonate group attenuated faster than in the sodium bicarbonate subgroup. Alcohol craving (assessed with OCDS) in the calcium carbonate subgroup was also significantly reduced versus the sodium bicarbonate subgroup. Conclusion: Our data support earlier findings and show that treatment with calcium carbonate during alcohol withdrawal reduces symptoms of alcohol withdrawal as well as alcohol craving in a controlled clinical pilot study. Mode of actions will need to be determined to allow the further development of pharmacological interventions beyond Ca2+ bis-acetyl-homotaurinate.

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Marahatta, K., J. Ma, P. M. S. Pradhan, M. Chapagain, P. Tulachan, and V. D. Sharma. "An open label comparison of efficacy of low dose topiramate with naltrexone in preventing alcohol relapse." Journal of Psychiatrists' Association of Nepal 4, no. 1 (February 21, 2017): 20–26. http://dx.doi.org/10.3126/jpan.v4i1.16738.

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Introduction: Alcohol use disorder is a relapsing and remitting disorder. Preventing alcohol relapses has been a difficult task. The available drugs do not have adequate outcome in diverse needs. Topiramate, a GABAergic anticonvulsant, has been useful for the prevention of alcohol relapse as demonstrated in western studies. We compared the efficacy of Topiramate at 100mg with Naltrexone 50 mg in preventing relapse among Nepalese alcohol dependence patients.Methods: Following an inpatient alcohol detoxification, 37 patients taking Topiramate 100 mg and 41 patients taking Naltrexone 50 mg were followed up as outpatients at 1, 4, 8 and 12 weeks in order to monitor their abstinence period, craving for alcohol and alcohol use pattern.Results: At the end of 12 weeks follow up, Topiramate is as good as Naltrexone 50 mg in terms of maintaining abstinence (27% vs 31.7%, p=0.651) and reducing the daily alcohol intake. Topiramate is better than Naltrexone in decreasing craving at 12 wks (p=0.015).Conclusion: Topiramate 100 mg is equally efficacious to Naltrexone 50 mg in reducing alcohol craving and maintaining abstinence.

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Karpyak, Victor M., Stacey J. Winham, Ulrich W. Preuss, Peter Zill, Julie M. Cunningham, Denise L. Walker, Kriste A. Lewis, et al. "Association of the PDYN gene with alcohol dependence and the propensity to drink in negative emotional states." International Journal of Neuropsychopharmacology 16, no. 5 (June 1, 2013): 975–85. http://dx.doi.org/10.1017/s1461145712001137.

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Abstract Synthetic κ-opioid receptor (KOR) agonists induce dysphoric and pro-depressive effects and variations in the KOR (OPRK1) and prodynorphin (PDYN) genes have been shown to be associated with alcohol dependence. We genotyped 23 single nucleotide polymorphisms (SNPs) in the PDYN and OPRK1 genes in 816 alcohol-dependent subjects and investigated their association with: (1) negative craving measured by a subscale of the Inventory of Drug Taking Situations; (2) a self-reported history of depression; (3) the intensity of depressive symptoms measured by the Beck Depression Inventory-II. In addition, 13 of the 23 PDYN and OPRK1 SNPs, which were previously genotyped in a set of 1248 controls, were used to evaluate association with alcohol dependence. SNP and haplotype tests of association were performed. Analysis of a haplotype spanning the PDYN gene (rs6045784, rs910080, rs2235751, rs2281285) revealed significant association with alcohol dependence (p = 0.00079) and with negative craving (p = 0.0499). A candidate haplotype containing the PDYN rs2281285-rs1997794 SNPs that was previously associated with alcohol dependence was also associated with negative craving (p = 0.024) and alcohol dependence (p = 0.0008) in this study. A trend for association between depression severity and PDYN variation was detected. No associations of OPRK1 gene variation with alcohol dependence or other studied phenotypes were found. These findings support the hypothesis that sequence variation in the PDYN gene contributes to both alcohol dependence and the induction of negative craving in alcohol-dependent subjects.

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Haass-Koffler, Carolina L., Rachel D. Souza, James P. Wilmott, Elizabeth R. Aston, and Joo-Hyun Song. "A Combined Alcohol and Smoking Cue-Reactivity Paradigm in People Who Drink Heavily and Smoke Cigarettes: Preliminary Findings." Alcohol and Alcoholism 56, no. 1 (September 28, 2020): 47–56. http://dx.doi.org/10.1093/alcalc/agaa089.

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Abstract Aims Previous studies have shown that there may be an underlying mechanism that is common for co-use of alcohol and tobacco and it has been shown that treatment for alcohol use disorder can increase rates of smoking cessation. The primary aim of this study was to assess a novel methodological approach to test a simultaneous behavioral alcohol-smoking cue reactivity (CR) paradigm in people who drink alcohol and smoke cigarettes. Methods This was a human laboratory study that utilized a novel laboratory procedure with individuals who drink heavily (≥15 drinks/week for men; ≥8 drinks/week for women) and smoke (>5 cigarettes/day). Participants completed a CR in a bar laboratory and an eye-tracking (ET) session using their preferred alcohol beverage, cigarettes brand and water. Results In both the CR and ET session, there was a difference in time spent interacting with alcohol and cigarettes as compared to water (P’s < 0.001), but no difference in time spent interacting between alcohol and cigarettes (P > 0.05). In the CR sessions, craving for cigarettes was significantly greater than craving for alcohol (P < 0.001), however, only time spent with alcohol, but not with cigarettes, was correlated with craving for both alcohol and cigarettes (P < 0.05). Conclusion This study showed that it is feasible to use simultaneous cues during a CR procedure in a bar laboratory paradigm. The attention bias measured in the integrated alcohol-cigarettes ET procedure predicted participants’ decision making in the CR. This novel methodological approach revealed that in people who drink heavily and smoke, alcohol cues may affect craving for both alcohol and cigarettes.

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Furieri, Fernando A., and Ester M. Nakamura-Palacios. "Gabapentin Reduces Alcohol Consumption and Craving." Journal of Clinical Psychiatry 68, no. 11 (November 15, 2007): 1691–700. http://dx.doi.org/10.4088/jcp.v68n1108.

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Wetterling, T., C. Veltrup, and K. Junghanns. "How to Assess Craving for Alcohol." European Addiction Research 3, no. 3 (1997): 110–15. http://dx.doi.org/10.1159/000259163.

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Mannelli, P., M. C. Mizzoni, L. Janiri, U. Lombardi, S. De Risio, and E. Tempesta. "Craving for alcohol and dopamine activity." Biological Psychiatry 42, no. 1 (July 1997): 35S. http://dx.doi.org/10.1016/s0006-3223(97)87015-1.

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Wayner, Matthew J. "Craving for alcohol in the rat." Pharmacology Biochemistry and Behavior 73, no. 1 (August 2002): 27–43. http://dx.doi.org/10.1016/s0091-3057(02)00780-3.

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Tiffany, Stephen T. "RELATIONSHIPS BETWEEN ALCOHOL CRAVING AND CONSUMPTION." Behavioural Pharmacology 10, SUPPLEMENT 1 (August 1999): S93. http://dx.doi.org/10.1097/00008877-199908001-00237.

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Kiefer, Falk, Holger Jahn, Marco Jaschinski, Rüdiger Holzbach, Karsten Wolf, Dieter Naber, and Klaus Wiedemann. "Leptin: a modulator of alcohol craving?" Biological Psychiatry 49, no. 9 (May 2001): 782–87. http://dx.doi.org/10.1016/s0006-3223(01)01081-2.

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Agrawal, Arpana, Leah Wetherill, Kathleen K. Bucholz, John Kramer, Samuel Kuperman, Michael T. Lynskey, John I. Nurnberger, et al. "Genetic influences on craving for alcohol." Addictive Behaviors 38, no. 2 (February 2013): 1501–8. http://dx.doi.org/10.1016/j.addbeh.2012.03.021.

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Herremans, S., N. Vanderbruggen, D. Zeeuws, L. Santermans, and C. Baeken. "The effect of right-sided prefrontal HF-rTMS on alcohol craving: Preliminary results." European Psychiatry 26, S2 (March 2011): 52. http://dx.doi.org/10.1016/s0924-9338(11)71763-1.

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IntroductionRepetitive transcranial magnetic stimulation (rTMS) affects neuronal circuits and neurotransmitter systems in the brain. Recent data suggest that this application could diminish ‘craving’ in patients with alcohol dependence.Objectives and aimsGiven these preliminary data, we examined whether one high frequency (HF)- rTMS session over the right dorsolateral prefrontal cortex (DLPFC) would reduce alcohol craving in alcohol dependent patients in their natural habitat.MethodsAfter detoxification during hospitalization, 22 current alcohol dependent inpatients were included (8 female, 14 male; age = 49.95 ± 8.82y).We used a sham-controlled between-subjects design where after randomization patients received under MRI guidance one right-sided DLPFC active HF-rTMS session or sham. In each high-frequency (20 Hz) stimulation session, patients received 1560 pulses at 110 % MT. The obsessive-compulsive drinking scale (OCDS) was collected at baseline, just before and just after the stimulation session on Friday after detoxification and on the three consecutive days following stimulation in patient's natural habitat.ResultsAlthough the OCDS total score significantly decreased after the detoxification period, one sham-controlled stimulation session did not affect immediate craving measurements. Furthermore, no significant group differences were observed on OCDS total scores when patients were in their natural habitat.ConclusionsAlthough the right DLPFC was targeted under MRI guidance, our preliminary results indicate that one sham-controlled HF-rTMS session does not affect craving in recently detoxified alcohol dependent patients. Besides the limited number of patients it could be possible that only one stimulation session could be insufficient to have a subjective effect on craving.

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Bollen, Zoé, Nicolas Masson, Samuel Salvaggio, Fabien D’Hondt, and Pierre Maurage. "Craving is everything: An eye-tracking exploration of attentional bias in binge drinking." Journal of Psychopharmacology 34, no. 6 (March 23, 2020): 636–47. http://dx.doi.org/10.1177/0269881120913131.

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Background: Attentional bias towards alcohol-related stimuli is a core characteristic of severe alcohol use disorders (AUD), directly linked to clinical variables (e.g. alcohol consumption, relapse). Nevertheless, the extent of this bias in subclinical populations remains poorly documented. This is particularly true for binge drinking, an alcohol consumption pattern highly prevalent in youth, characterised by an alternation between excessive intakes and withdrawal periods. Aims: We used eye-tracking to: (a) measure attentional bias in binge drinking, (b) determine its time course by dissociating early/late processing stages, (c) clarify its specificity for alcohol-related stimuli compared to other appetitive stimulations and (d) explore its modulation by current craving intensity. Methods: Binge drinkers ( n=42) and matched controls ( n=43) performed a visual probe task, requiring visual targets preceded by pairs of pictures to be processed, with three conditions (i.e. alcohol vs. soft drink, alcohol vs. high-calorie food, high-calorie food vs. low-calorie food). Results: No group difference was observed for early processing (i.e. first area of interest visited). Dwell times highlighted a bias towards soft drinks and healthy food among controls, without any global bias towards alcohol in binge drinkers. Centrally, a comparison of binge drinkers with low versus high current craving intensity indicated that binge drinking was associated with a bias towards alcohol and high-calorie food only in the presence of a high craving towards these stimuli. Conclusion: Attentional bias towards alcohol reported in severe AUD is only found in binge drinkers in the presence of high craving and is generalised to other appetitive cues.

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Hartwell, Emily E., Spencer Bujarski, ReJoyce Green, and Lara A. Ray. "Convergence between the Penn Alcohol Craving Scale and diagnostic interview for the assessment of alcohol craving." Addictive Behaviors Reports 10 (December 2019): 100198. http://dx.doi.org/10.1016/j.abrep.2019.100198.

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Journal articles on the topic 'Alcohol craving'

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