Dataset Information

Opioid Craving in Human Laboratory Settings: a Review of the Challenges and Limitations.

ABSTRACT: There are many factors that need to be taken into consideration when measuring craving in a human laboratory study. This review summarizes and discusses some of the major challenges researchers are faced with when assessing opioid craving in clinical research. First, there are wide range of available assessments that have been developed for measuring craving and depending on the research questions or the underlying constructs targeted, some may be more appropriate than others. In addition to establishing the methodological point of departure for designing a study with craving, there are also different participant conditions and characteristics that need to be evaluated when selecting among the large selection of assessments available. Participant conditions/characteristics can influence the degree or frequency of opioid craving experienced. Lastly, there can be contextual conditions that affect opioid cravings such as a stressful environment that may alter cue saliency. It is recommended that researchers carefully consider the different constituents that contribute to opioid craving and to ensure a comprehensive evaluation when assessing each participant. A more thorough consideration of these challenges can help us to understand the optimal ways to measure one important and complex component of addiction.

SUBMITTER: Goodyear K

PROVIDER: S-EPMC7007448 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Opioid Craving in Human Laboratory Settings: a Review of the Challenges and Limitations.

Goodyear Kimberly K Haass-Koffler Carolina L CL

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 20200101 1

There are many factors that need to be taken into consideration when measuring craving in a human laboratory study. This review summarizes and discusses some of the major challenges researchers are faced with when assessing opioid craving in clinical research. First, there are wide range of available assessments that have been developed for measuring craving and depending on the research questions or the underlying constructs targeted, some may be more appropriate than others. In addition to est ...[more]

PMID: 31650431

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Project description:RATIONALE:Drug-related cues evoke craving and stimulate motivational systems in the brain. The acoustic startle reflex captures activation of these motivational processes and affords a unique measure of reactivity to drug cues. OBJECTIVES:This study examined the effects of cannabis-related cues on subjective and eye blink startle reactivity in the human laboratory and tested whether these effects predicted youth's cue-elicited cannabis craving in the natural environment. METHODS:Participants were 55 frequent cannabis users, ages 16 to 24 years (M?=?19.9, SD?=?1.9; 55% male; 56% met criteria for cannabis dependence), who were recruited from a clinical trial to reduce cannabis use. Eye blink electromyographic activity was recorded in response to acoustic probes that elicited startle reactivity while participants viewed pleasant, unpleasant, neutral, and cannabis picture cues. Following the startle assessment, participants completed an ecological momentary assessment protocol that involved repeated assessments of cue-elicited craving in real time in their real-world environments. RESULTS:Multilevel models included the presence or absence of visible cannabis cues in the natural environment, startle magnitude, and the cross-level interaction of cues by startle to test whether cue-modulated startle reactivity in the laboratory was associated with cue-elicited craving in the natural environment. Analyses showed that cannabis-related stimuli evoked an appetitive startle response pattern in the laboratory, and this effect was associated with increased cue-elicited craving in the natural environment, b?=?- 0.15, p?=?.022, 95% CI [- 0.28, - 0.02]. Pleasant stimuli also evoked an appetitive response pattern, but in this case, blunted response was associated with increased cue-elicited craving in the natural environment, b?=?0.27, p?<?.001, 95% CI [0.12, 0.43]. CONCLUSIONS:Our findings support cue-modulated startle reactivity as an index of the phenotypic expression of cue-elicited cannabis craving.

Project description:ObjectiveThe objective of this narrative review is to outline the current epidemiology and interventional research within the context of sepsis recovery, and to provide a summary of key priorities for future work in this area.BackgroundMorbidity and mortality secondary to sepsis disproportionately affects children, especially those in low- and middle-income countries (LMICs), where over 85% of global cases and deaths occur. These regions are plagued by poorly resilient health systems, widespread socio-economic deprivation and unique vulnerabilities such as malnutrition. Reducing the overall burden of sepsis will require a multi-pronged strategy that addresses all three important periods along the sepsis care continuum - pre-facility, facility and post-facility. Of these aspects, post-facility issues have been largely neglected in research, practice and policy, and are thus the focus of this review.MethodsRelevant data for this review was identified through a literature search using PubMed, through a review of the citations of select systematic reviews and from the personal repositories of articles collected by the authors. Data is presented within three sections. The first two sections on the short and long-term outcomes among sepsis survivors each outline the epidemiology as well as review relevant interventional research done. Where clear gaps exist, these are stated. The third section focuses on priorities for future research. This section highlights the importance of data (and data systems) and of innovative interventional approaches, as key areas to improve research of post-sepsis outcomes in children.ConclusionsDuring the initial post-facility period, mortality is high with as many children dying during this period as during the acute period of hospitalization, mostly due to recurrent illness (including infections) which are associated with malnutrition and severe acute disease. Long-term outcomes, often labelled as post-sepsis syndrome (PSS), are characterized by a lag in developmental milestones and suboptimal quality of life (QoL). While long-term outcomes have not been well characterized in resource limited settings, they are well described in high-income countries (HICs), and likely are important contributors to long-term morbidity in resource limited settings. The paucity of interventional research to improve post-discharge outcomes (short- or long-term) is a clear gap in addressing its burden. A focus on the development of improved data systems for collecting routine data, standardized definitions and terminology and a health-systems approach in research need to be prioritized during any efforts to improve outcomes during the post-sepsis phase.

Dataset Information

Opioid Craving in Human Laboratory Settings: a Review of the Challenges and Limitations.

Publications

Opioid Craving in Human Laboratory Settings: a Review of the Challenges and Limitations.

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