TY - JOUR
KW - Adult
KW - Affect
KW - Buprenorphine/therapeutic use
KW - Craving/physiology
KW - Female
KW - Humans
KW - Male
KW - Methadone/therapeutic use
KW - Middle Aged
KW - Narcotics/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy/psychology
KW - Outpatients
KW - smartphone
KW - Stress, Psychological/psychology
KW - cocaine
KW - craving
KW - Ecological momentary assessment
KW - Heroin
KW - stress
AU - K. L. Preston
AU - W. J. Kowalczyk
AU - K. A. Phillips
AU - M. L. Jobes
AU - M. Vahabzadeh
AU - J. L. Lin
AU - M. Mezghanni
AU - D. H. Epstein
A1 - 
AB - RATIONALE: Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile "just in time" treatment. OBJECTIVES: The purpose of this paper is to examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies. METHODS: For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated an entry whenever they experienced a stressful event (SE) and when randomly prompted (RP) three times daily. Participants reported the severity of stress and craving and the context of the report (location, activities, companions). Decomposition of covariance was used to separate within-person from between-person effects; r effect sizes below are within-person. RESULTS: Participants (158 of 182; 87%) made 1787 stress-event entries. Craving for opioids increased with stress severity (r effect = 0.50). Stress events tended to occur in social company (with acquaintances, 0.63, friends, 0.17, or on the phone, 0.41) rather than with family (spouse, -0.14; child, -0.18), and in places with more overall activity (bars, 0.32; outside, 0.28; walking, 0.28) and more likelihood of unexpected experiences (with strangers, 0.17). Being on the internet was slightly protective (-0.22). Our prior finding that being at the workplace protects against background stress in our participants was partly supported in these stressful-event data. CONCLUSIONS: The contexts of specific stressful events differ from those we have seen in prior studies of ongoing background stress. However, both are associated with drug craving.
AD - Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA. kpreston@intra.nida.nih.gov.; Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA.; Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA.; Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA.; Biomedical Informatics Section, Administrative Management Branch, Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Biomedical Informatics Section, Administrative Management Branch, Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Biomedical Informatics Section, Administrative Management Branch, Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA.
BT - Psychopharmacology
C5 - HIT & Telehealth; Opioids & Substance Use
CP - 17
CY - Germany
DO - 10.1007/s00213-017-4663-0
IS - 17
JF - Psychopharmacology
M1 - Journal Article
N2 - RATIONALE: Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile "just in time" treatment. OBJECTIVES: The purpose of this paper is to examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies. METHODS: For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated an entry whenever they experienced a stressful event (SE) and when randomly prompted (RP) three times daily. Participants reported the severity of stress and craving and the context of the report (location, activities, companions). Decomposition of covariance was used to separate within-person from between-person effects; r effect sizes below are within-person. RESULTS: Participants (158 of 182; 87%) made 1787 stress-event entries. Craving for opioids increased with stress severity (r effect = 0.50). Stress events tended to occur in social company (with acquaintances, 0.63, friends, 0.17, or on the phone, 0.41) rather than with family (spouse, -0.14; child, -0.18), and in places with more overall activity (bars, 0.32; outside, 0.28; walking, 0.28) and more likelihood of unexpected experiences (with strangers, 0.17). Being on the internet was slightly protective (-0.22). Our prior finding that being at the workplace protects against background stress in our participants was partly supported in these stressful-event data. CONCLUSIONS: The contexts of specific stressful events differ from those we have seen in prior studies of ongoing background stress. However, both are associated with drug craving.
PP - Germany
PY - 2017
SN - 1432-2072; 0033-3158
SP - 2631
EP - 2642
EP - 
T1 - Context and craving during stressful events in the daily lives of drug-dependent patients
T2 - Psychopharmacology
TI - Context and craving during stressful events in the daily lives of drug-dependent patients
U1 - HIT & Telehealth; Opioids & Substance Use
U2 - 28593441
U3 - 10.1007/s00213-017-4663-0
VL - 234
VO - 1432-2072; 0033-3158
Y1 - 2017
Y2 - Sep
ER -