Affect and craving are dynamic processes that are clinically relevant in opioid use disorder (OUD) treatment, and can be quantified in terms of intra-individual variability and stability. The purpose of the present analysis was to explore associations between opioid use and variability and stability of affect and craving among individuals receiving medication treatment for OUD (MOUD). Adults (N = 224) with OUD in outpatient methadone or buprenorphine treatment completed ecological momentary assessment (EMA) prompts assessing positive affect, negative affect, opioid craving, and opioid use. Dynamic structural equation modeling (DSEM) was used to quantify person-level indices of magnitude and stability of change. Beta regression was used to examine associations between intra-individual variability and stability and proportion of opioid-use days, when controlling for overall intensity of affect and craving. Results suggested that greater magnitude of craving variability was associated with opioid use on a greater proportion of days, particularly among individuals with lower average craving. Low average positive affect was also associated with higher proportion of days of use. Individuals who experience substantial craving variability in the context of lower average craving may be particularly vulnerable to opioid use during treatment. Ongoing assessment of craving may be useful in identifying treatment needs. Examining correlates of intra-individual variability and stability in MOUD treatment remains a relevant direction for future work.
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This study was supported by the Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health and the National Institute on Drug Abuse T32 DA007209 (Strain, Bigelow, Weerts) and F32 DA04939302 (Mun).
PHF is on the scientific advisory board for Ninnion. The other authors report no conflicts of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The original online version of this article was revised to correct typos in the abstract and results section.
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Ellis, J.D., Mun, C.J., Epstein, D.H. et al. Intra-individual variability and stability of affect and craving among individuals receiving medication treatment for opioid use disorder. Neuropsychopharmacol. 47, 1836–1843 (2022). https://doi.org/10.1038/s41386-022-01352-y