title: Effects of alcohol availability, access to alcohol, and naltrexone on self-reported craving and patterns of drinking in response to an alcohol-cue availability procedure.
abstract: OBJECTIVE
  Craving has long been cited by patients and providers as a principal construct in alcohol use disorders and an essential target for treatment. The goal of the current study was to examine the effects of alcohol availability (20% vs. 80% availability), access to alcohol ("open" vs. "locked" trials), and medication (oral naltrexone [Revia] vs. placebo) on self-reported craving and two behavioral measures of drinking (latency of attempt to access alcohol, amount of alcohol consumed when access permitted) in response to an alcohol-cue availability procedure.
  
  
  METHODS
  Non-treatment-seeking, alcohol-dependent men and women (N = 58) self-referred for an alcohol administration study and were administered a modified alcohol-cue availability procedure under two medication conditions (naltrexone, placebo) using a within-subjects, repeated-measures design.
  
  
  RESULTS
  Analyses demonstrated that the experimental manipulations used in this study had differential effects on craving and patterns of drinking. Specifically, reduced availability of alcohol (i.e., when alcohol was available in only 20% as opposed to 80% of trials) resulted in greater amounts of alcohol consumed per open trial; the unanticipated blocking of access to alcohol (i.e., a "locked" trial during the 80% availability condition) triggered more rapid attempts to obtain alcohol on subsequent trials. Naltrexone, relative to placebo, was associated with significant reductions in cravings for alcohol.
  
  
  CONCLUSIONS
  Taken together, these findings offer partial support for the cognitive processing model and reinforce the utility of evaluating both self-report and behavioral indicators of motivation to drink in studies designed to identify factors associated with the construct of craving.
authors.affiliation: VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA. Marc.Kruse@austintexas.gov
authors.forename: Marc I
authors.initials: MI
authors.lastname: Kruse
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Radnovich
authors.forename: Raj K
authors.initials: RK
authors.lastname: Kalapatapu
authors.forename: Nicole
authors.initials: N
authors.lastname: Mehdiyoun
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Chambers
authors.forename: Dena
authors.initials: D
authors.lastname: Davidson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000188:drug therapy* / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology*; D016739:Behavior, Addictive / Q000188:drug therapy* / Q000523:psychology*; D003463:Cues; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D000431:Ethanol / Q000494:pharmacology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000494:pharmacology / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D057566:Self Report
chemical_list: D009292:Narcotic Antagonists; D000431:Ethanol; D009271:Naltrexone