Craving is arguably the most contentious construct in addiction research. On the one hand are the testimonials of alcoholics that cravings dominate their thoughts and weaken their resolve to stay sober. On the other hand, research finds that craving is neither necessary nor sufficient to explain drinking. In 1996, the NIAAA brought together addiction experts to determine why craving is not a reliable predictor of drinking. One of the gaps in the knowledge base identified by this group was that craving has not been adequately conceptualized and studied in humans. Lack of such research is an important problem because it impedes the understanding of the nature, course, behavioral sequelae, and regulatory function of craving on alcohol consumption. The long-term goal of my research is to better understand the phenomenon of craving and its relation to drinking and relapse. The objective of this application is to examine 2 influential models of craving, the Cognitive Processing Model of Craving and Drug Use, and the Two-Affect Model of Urges and Drug Motivation, which yield different predictions regarding the association between craving and drinking. The central hypothesis of the proposed research is that the circumstances under which craving is likely to predict drinking will only be elucidated through theory-driven research and the use of paradigms that can manipulate factors known to elicit drinking, and simultaneously measure craving and drinking behavior. Three studies are proposed to investigate factors known to elicit drinking in alcoholics by using an innovative modification of conventional cue-reactivity methodology-the cue-availability paradigm. Study I will examine the effects of alcohol priming and alcohol availability on craving, affect, alcohol seeking, and drinking behavior in non treatment-seeking alcoholics. Study 2 will examine the effects of negative mood induction and alcohol availability on craving, affect, alcohol seeking, and drinking behavior in non treatment-seeking alcoholics. Study 3 will replicate and add to the findings from Study 2 by providing a test of convergent validity on drinking behaviors measured by the cue-availability paradigm to similar measures assessed by a validated taste-rating task. The effects of participating in these laboratory alcohol administration studies on subsequent ad libitum drinking will be measured as a secondary aim. The proposed research is innovative because it uses a paradigm that has the flexibility to manipulate factors known to affect alcohol seeking and drinking behaviors, simultaneously measures craving and affect, and tests two models of craving. We expect that this research will provide important new information regarding factors that moderate craving, and the association between craving and drinking in the population of interest-alcoholics. The major impact of this research will be to address a gap in the knowledge base regarding the conceptualization of craving in humans, which in turn will advance the field and inform patient care.
| Kruse, Marc I; Radnovich, Alexander J; Kalapatapu, Raj K et al. (2012) 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. J Stud Alcohol Drugs 73:205-15 |
