Addiction Rehab: Implicit and Explicit Drug-Related Cognitions During Detoxification Treatment Are Associated With Drug Relapse: An Ecological Momentary Assessment Study.

Implicit and Explicit Drug-Related Cognitions During Detoxification Treatment Are Associated With Drug Relapse: An Ecological Momentary Assessment Study.

Filed under: Addiction Rehab

J Consult Clin Psychol. 2012 Dec 10;
Marhe R, Waters AJ, van de Wetering BJ, Franken IH

Objective: Relapse is a major problem in drug addiction treatment. Both drug craving and drug-related cognitions (e.g., attentional bias and implicit attitudes to drugs) may contribute to relapse. Using ecological momentary assessments, we examined whether craving and cognitions assessed during drug detoxification treatment were associated with relapse. Method: Participants were 68 heroin-dependent inpatients undergoing clinical detoxification at an addiction treatment center. Participants carried around a personal digital assistant for 1 week. Participants completed up to 4 random assessments (RAs) per day. They also completed an assessment when they experienced a temptation to use drugs (TA). At each assessment, participants reported their craving and attitudes to drugs. Implicit cognitions were assessed with a drug Stroop task (attentional bias) and an Implicit Association Test (implicit attitudes). Results: Individuals who relapsed during the study week exhibited a larger attentional bias and more positive implicit attitudes to drugs than did nonrelapsers at TAs (but not RAs). In addition, compared to nonrelapsers, relapsers reported higher levels of craving and more positive explicit attitudes to drugs at TAs than at RAs. Additional within-subject analyses revealed that attentional bias for drugs at TAs increased before relapse. Conclusions: Drug-related cognitive processes assessed with ecological momentary assessments were associated with relapse during drug detoxification. Real-time assessment of craving and cognitions may help to identify which individuals are at risk of relapse and when they are at risk of relapse. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
HubMed – addiction

Neural network activation during a stop-signal task discriminates cocaine-dependent from non-drug-abusing men.

Filed under: Addiction Rehab

Addict Biol. 2012 Dec 12;
Elton A, Young J, Smitherman S, Gross RE, Mletzko T, Kilts CD

Cocaine dependence is defined by a loss of inhibitory control over drug-use behaviors, mirrored by measurable impairments in laboratory tasks of inhibitory control. The current study tested the hypothesis that deficits in multiple subprocesses of behavioral control are associated with reliable neural-processing alterations that define cocaine addiction. While undergoing functional magnetic resonance imaging (fMRI), 38 cocaine-dependent men and 27 healthy control men performed a stop-signal task of motor inhibition. An independent component analysis on fMRI time courses identified task-related neural networks attributed to motor, visual, cognitive and affective processes. The statistical associations of these components with five different stop-signal task conditions were selected for use in a linear discriminant analysis to define a classifier for cocaine addiction from a subsample of 26 cocaine-dependent men and 18 controls. Leave-one-out cross-validation accurately classified 89.5% (39/44; chance accuracy?=?26/44?=?59.1%) of subjects with 84.6% (22/26) sensitivity and 94.4% (17/18) specificity. The remaining 12 cocaine-dependent and 9 control men formed an independent test sample, for which accuracy of the classifier was 81.9% (17/21; chance accuracy?=?12/21?=?57.1%) with 75% (9/12) sensitivity and 88.9% (8/9) specificity. The cocaine addiction classification score was significantly correlated with a measure of impulsiveness as well as the duration of cocaine use for cocaine-dependent men. The results of this study support the ability of a pattern of multiple neural network alterations associated with inhibitory motor control to define a binary classifier for cocaine addiction.
HubMed – addiction

Patients’ experience of auricular acupuncture during protracted withdrawal.

Filed under: Addiction Rehab

J Psychiatr Ment Health Nurs. 2012 Dec 12;
Bergdahl L, Berman AH, Haglund K

ACCESSIBLE SUMMARY: ??Interest has grown in complementary treatment methods such as acupuncture. In addiction treatment auricular acupuncture has been used to relieve difficult abstinence symptoms. The specific protocol used follows the definition used by the National Acupuncture Detoxification Association (NADA). ??The report describes 15 patients’ experiences of receiving auricular acupuncture during the abstinence period after elimination of problematic alcohol and illicit drug use. ??The patients in the study mainly experienced positive effects of receiving NADA. The greatest gains were a reinforced sense of relaxation and well-being, peacefulness and harmony, and new behaviours. The treatment supported some of the respondents in staying away from alcohol and drugs and it ameliorated their abstinence symptoms. No one experienced any negative side-effects. ABSTRACT: Over the last decades interest in using auricular acupuncture for substance dependence care has increased. The specific auricular acupuncture protocol used follows the National Acupuncture Detoxification Association (NADA) definition. This paper describes patients’ experiences of receiving auricular acupuncture during protracted withdrawal. Interviews were conducted with 15 patients treated at an outpatient clinic for substance dependence. Content analysis was used to analyse the interviews. The analysis resulted in seven categories of positive experiences and seven categories of negative experiences. The positive experiences were: Relaxation and well-being, Peacefulness and harmony, New behaviours, Positive physical impact, Importance of context, Anxiety reduction and Reduced drug and alcohol consumption. The negative experiences were: Nothing negative, Disturbing context, Short-term effect, Depending on someone else, Time-consuming, Physical distractions and Remaining cravings. The conclusion of this study is that all respondents appreciated NADA treatment. This study supports further research on using NADA in addiction treatment to reduce suffering during protracted withdrawal and in other contexts.
HubMed – addiction

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