Document Detail


Alcohol craving as a predictor of relapse.
MedLine Citation:
PMID:  23786506     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background and Objectives: Alcoholism treatment interventions, both psychosocial and pharmacologic, aim to reduce cravings to drink. Yet, the role of craving in treatment outcomes remains unclear. This study evaluated craving intensity measured with the Penn Alcohol Craving Scale (PACS) at admission and discharge from residential treatment as a predictive factor of relapse after treatment. Methods: The study cohort included 314 alcohol-dependent subjects. Associations between relapse after discharge, PACS score, and clinical variables were investigated using time-to-event analyses. The primary analysis, based on the intent-to-treat principle, presumed relapse in those declining follow-up or not responding to contact attempts. Secondary analysis utilized data from 226 subjects successfully contacted after discharge with a median follow-up time of 365 days. Results: The intent-to-treat analysis demonstrated that relapse was associated with higher level of craving at admission (p= .002) and discharge (p < .001). The analysis of data from patients successfully contacted after discharge led to similar results. A multivariable analysis indicated that relapse rates increased as PACS scores increased, and a higher discharge PACS score was significantly associated with relapse (p= .006) even after adjusting for covariates. Conclusions and Scientific Significance: This study demonstrates that higher PACS scores at the time of admission and discharge are associated with relapse following residential addiction treatment. These data support the role of craving in relapse and the utility of craving measurement as a clinical guide in assessing relapse risk. (Am J Addict 2012;21:S20-S26).
Authors:
Terry D Schneekloth; Joanna M Biernacka; Daniel K Hall-Flavin; Victor M Karpyak; Mark A Frye; Larissa L Loukianova; Susanna R Stevens; Maureen S Drews; Jennifer R Geske; David A Mrazek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions     Volume:  21 Suppl 1     ISSN:  1521-0391     ISO Abbreviation:  Am J Addict     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-06-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208821     Medline TA:  Am J Addict     Country:  England    
Other Details:
Languages:  eng     Pagination:  S20-6     Citation Subset:  IM    
Copyright Information:
Copyright © American Academy of Addiction Psychiatry.
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota Duke Clinical Research Institute, Durham, North Carolina.
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