title: Substance use and hepatitis C: an ecological momentary assessment study.
abstract: OBJECTIVE
  The objective of this study was to assess craving and mood related to opioid and cocaine use among asymptomatic hepatitis C virus (HCV)+ and HCV- methadone patients who have not started antiviral treatment.
  
  
  METHODS
  In this 28-week prospective ecological momentary assessment (EMA) study, 114 methadone-maintained, heroin- and cocaine-abusing individuals reported from the field in real time on their mood, craving, exposure to drug-use triggers, and drug use via handheld computers.
  
  
  RESULTS
  Sixty-one percent were HCV+; none were overtly symptomatic or receiving HCV treatment. HCV status was not associated with age, sex, race, or past-30-day or lifetime heroin or cocaine use. In event-contingent EMA entries, HCV+ individuals more often attributed use to having been bored, worried, or sad; feeling uncomfortable; or others being critical of them compared with HCV- participants. In randomly prompted EMA entries, HCV+ participants reported significantly more exposure to drug-use triggers, including handling ≥$10, seeing cocaine or heroin, seeing someone being offered/use cocaine or heroin, being tempted to use cocaine, and wanting to see what would happen if they used just a little cocaine or heroin.
  
  
  CONCLUSIONS
  HCV+ individuals experienced more negative moods and more often cited these negative moods as causes for drug use. HCV+ individuals reported greater exposure to environmental drug-use triggers, but they did not more frequently cite these as causes for drug use. The EMA data reported here suggest that HCV+ intravenous drug users may experience more labile mood and more reactivity to mood than HCV- intravenous drug users. The reason for the difference is not clear, but HCV status may be relevant to tailoring of treatment.
authors: National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
authors: Karran A
authors: KA
authors: Phillips
authors: National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
authors: David H
authors: DH
authors: Epstein
authors: National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
authors: Massoud
authors: M
authors: Vahabzadeh
authors: Johns Hopkins Bayview Medical Center.
authors: Mustapha
authors: M
authors: Mezghanni
authors: National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
authors: Jia-Ling
authors: JL
authors: Lin
authors: National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
authors: Kenzie L
authors: KL
authors: Preston
mesh_terms: D000328:Adult; D000339:Affect; D000998:Antiviral Agents / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000523:psychology*; D066249:Craving; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy / Q000523:psychology*; D006556:Heroin Dependence / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012309:Risk-Taking
chemical_list: D000998:Antiviral Agents; D008691:Methadone