Abstract
Treating withdrawal and post-abstinence craving have had mixed success in eliminating drug use, improving outcomes and reducing relapse. To assess the role of craving and withdrawal in continued drug use we analyzed data at 6 and 12 month follow-up contacts from 1,626 patients voluntarily admitted to a primary rehabilitation center. 42% were diagnosed as alcohol dependent (AD) alone. The AD group had the best outcomes and the least slippage. In all groups craving was not a major self-reported cause of relapse. In the AD group, the most common reason was depression. In fact, 300% more patients cited depression, compared to craving, as the reason for their relapse. These data agree with other reports in the literature suggesting that relapse is not commonly related to craving. Subtle chemical changes in the abstinent brain associated with withdrawal may support the continuation of alcohol use but may not be consciously recognized. Markers for withdrawal-related dysphoria vs. depression may be needed to target improve treatment outcome.
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Gold, M., Miller, N. & Hoffmannl, N. Depression vs. Craving In Alcoholic Relapse. Neuropsychopharmacol 11, 271 (1994). https://doi.org/10.1038/sj.npp.1380156
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DOI: https://doi.org/10.1038/sj.npp.1380156