title: Craving predicts opioid use in opioid-dependent patients initiating buprenorphine treatment: a longitudinal study.
abstract: BACKGROUND
  Few studies have assessed associations between craving and subsequent opioid use. We prospectively evaluated the relative utility of two craving questionnaires to predict opioid use among opioid-dependent patients in outpatient treatment.
  
  
  METHODS
  Opioid-dependent patients (n = 147) initiating buprenorphine treatment were assessed every two weeks for 3 months. Craving was measured using the: (1) Desires for Drug Questionnaire (DDQ) and (2) Penn Alcohol-Craving Scale adapted for opioid craving (PCS). Multi-level logistic regression models estimated the effects of craving on the likelihood of opioid use. Craving assessed at time t was entered as a time-varying predictor of opioid use at time t + 1.
  
  
  RESULTS
  Craving scores plateaued at approximately 2 weeks after initiation of buprenorphine. In adjusted regression models, a 1-point increase in PCS scores (on a 7-point scale) was associated with a significant increase in the odds of opioid use at the subsequent assessment (OR = 1.27, 95% CI 1.08; 1.49, p < 0.01). The odds of opioid use at the subsequent follow-up assessment increased significantly as DDQ desire and intention scores increased (OR = 1.25, 95%CI 1.03; 1.51, p < 0.05), but was not significantly associated with DDQ negative reinforcement (OR = 1.01, 95%CI 0.88; 1.17, p > 0.05) or DDQ control (OR = 0.97, 95%CI 0.85; 1.11, p > 0.05) scores.
  
  
  CONCLUSIONS
  Self-reported craving for opioids was modestly associated with subsequent relapse to opioid use among a cohort of patients treated with buprenorphine. Assessment of craving may provide clinical utility in predicting relapse among treated opioid-dependent patients.
authors: Boston University School of Medicine/Boston Medical Center , Boston MA , USA .
authors: Judith I
authors: JI
authors: Tsui
authors: Bradley J
authors: BJ
authors: Anderson
authors: David R
authors: DR
authors: Strong
authors: Michael D
authors: MD
authors: Stein
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012008:Recurrence; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D002047:Buprenorphine