Tobacco, cocaine, and heroin: Craving and use during daily life
Tobacco, cocaine, and heroin: Craving and use during daily life
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DOI：
10.1016/j.addbeh.2009.11.003
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发表时间：
2010-04-01
影响因子：
4.4
通讯作者：
Preston, Kenzie L.
中科院分区：
文献类型：
--
作者：
Epstein, David H.;Marrone, Gina F.;Preston, Kenzie L.
背景：吸烟、烟草渴求以及其他药物使用和渴求之间的关系可能对多药依赖个体具有治疗意义。方法：我们进行了第一项生态瞬时评估(EMA)研究，以探讨吸烟与日常生活中其他药物使用和渴求的关系。在长达20周的时间里，106名服用美沙酮的门诊患者使用PalmPilot(掌上电脑)。他们每天在2-5个随机提示条目中报告自己的渴望、情绪、行为、环境和吸烟状况，并在使用可卡因或海洛因或有对可卡因或海洛因的单独渴望时启动PDA条目。吸烟频率随着随机提示的烟草渴望、可卡因渴望以及对可卡因和海洛因的渴望而线性增加。在可卡因使用和渴求的离散发作期间，吸烟频率比随机提示报告的对可卡因的低渴求期间更高。这种模式对可卡因和海洛因的双重使用和渴求也很重要。在尿检证实的可卡因戒断期间，吸烟和烟草渴求均显著减少，并且在此期间早晨吸烟有减少的趋势(不显著)。结论：这项EMA研究证实吸烟和烟草渴求与可卡因和海洛因的使用和渴求密切相关。结合之前的发现，我们的数据表明，烟草和可卡因可能都会增加对自己和彼此的渴望(以及继续使用的可能性)。烟草依赖的治疗可能应该与其他物质使用障碍的治疗同时进行(而不是仅在开始治疗之后)。爱思唯尔有限公司出版。
Background: Relationships among tobacco smoking, tobacco craving, and other drug use and craving may have treatment implications in polydrug-dependent individuals.Methods: We conducted the first ecological momentary assessment (EMA) study to investigate how smoking is related to other drug use and craving during daily life. For up to 20 weeks, 106 methadone-maintained outpatients carried PalmPilots (PDAs). They reported their craving, mood, behaviors, environment, and cigarette-smoking status in 2 to 5 random-prompt entries/day and initiated PDA entries when they used cocaine or heroin or had a discrete episode of craving for cocaine or heroin.Results. Smoking frequency increased linearly with random-prompt ratings of tobacco craving, cocaine craving, and craving for both cocaine and heroin. Smoking frequency was greater during discrete episodes of cocaine use and craving than during random-prompt reports of low craving for cocaine. This pattern was also significant for dual cocaine and heroin use and craving. Smoking and tobacco craving were each considerably reduced during periods of urine-verified abstinence from cocaine, and there was a (nonsignificant) tendency for morning smoking to be especially reduced during those periods.Conclusions: This EMA study confirms that smoking and tobacco craving are strongly associated with the use of and craving for cocaine and heroin. Together with prior findings, our data suggest that tobacco and cocaine may each increase craving for (and likelihood of continued use of) themselves and each other. Treatment for tobacco dependence should probably be offered concurrently with (rather than only after) initiation of treatment for other substance-use disorders. Published by Elsevier Ltd.