What Makes Alcohol-Dependent Individuals Early in Abstinence Crave for Alcohol: Exposure to the Drink, Images of Drinking, or Remembrance of Drinks Past?

Authors

  • Aviv Weinstein,

    Corresponding author
    1. Psychopharmacology Unit Medical School (A. W.), University of Bristol, Bristol, UK; Institute of Psychiatry (A.L.-H.), London, UK National Alcohol Unit (J.M.R.), Bethlem and Maudsley NHS Trust, London, UK; and the National Alcohol Unit (J.M.), London, UK
      Reprint requests: Aviv Weinstein, Ph.D., Brain Imaging Center, National Institute on Drug Abuse, Intramural Research Program, 5500 Nathan Shock Drive, Baltimore, MD 21224.
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  • Anne Lingford-Hughes,

    1. Psychopharmacology Unit Medical School (A. W.), University of Bristol, Bristol, UK; Institute of Psychiatry (A.L.-H.), London, UK National Alcohol Unit (J.M.R.), Bethlem and Maudsley NHS Trust, London, UK; and the National Alcohol Unit (J.M.), London, UK
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  • Jose Martinez-Raga,

    1. Psychopharmacology Unit Medical School (A. W.), University of Bristol, Bristol, UK; Institute of Psychiatry (A.L.-H.), London, UK National Alcohol Unit (J.M.R.), Bethlem and Maudsley NHS Trust, London, UK; and the National Alcohol Unit (J.M.), London, UK
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  • Jane Marshall

    1. Psychopharmacology Unit Medical School (A. W.), University of Bristol, Bristol, UK; Institute of Psychiatry (A.L.-H.), London, UK National Alcohol Unit (J.M.R.), Bethlem and Maudsley NHS Trust, London, UK; and the National Alcohol Unit (J.M.), London, UK
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Reprint requests: Aviv Weinstein, Ph.D., Brain Imaging Center, National Institute on Drug Abuse, Intramural Research Program, 5500 Nathan Shock Drive, Baltimore, MD 21224.

Abstract

Craving is a major factor in addiction, predicting poorer outcome to treatment. To improve our understanding of craving for alcohol, we have compared in the laboratory the effects of inducting craving for alcohol by exposure to the sight and the smell of an alcoholic beverage, imagery of craving scripts, and recall of autobiographical memories of craving. We used subjective measures of craving, together with autonomic measures, in 14 abstinent alcohol-dependent individuals in the first month after detoxification. All subjects reported a significant increase in ratings of urges after exposure to alcoholic drinks, following the imagery of craving and after recalling autobiographical memories of craving. Physiological measures have shown that craving imagery as well as memory induction were equally effective as exposure to alcoholic drinks in modestly increasing autonomic arousal (indicated by systolic blood pressure). Our preliminary findings support the existing evidence in nicotine and opiate dependence that images and memories are as effective as in vivo exposure in eliciting craving for drugs.

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