Personalized Cocaine Cues Measured a Change in Craving

The primary craving measure was the change around a personalized cocaine-cue imagery exercise. It was not simply each participant’s absolute craving score on an ordinary day.

The challenge was constructed for each participant

During inpatient treatment, researchers developed neutral, cocaine-related and stressful scenarios from participants’ experiences. Each was recorded as a five-minute guided imagery script. On day eight, scenario order was counterbalanced and randomized. The cocaine-cue outcome subtracted the pre-exercise craving rating from the post-exercise rating on a zero-to-ten scale.

Change and level answer different questions

A participant can start with substantial craving yet show a small challenge-related increase, or start lower and show a larger increase. The change score addresses acute cue reactivity under that procedure. It does not by itself measure all daily craving, actual cocaine consumption or the likelihood of relapse in an uncontrolled environment.

The comparison remained negative

CBD did not establish superiority over placebo on this primary challenge outcome. The study also evaluated other craving and use measures, which should be named separately rather than merged into one score. The personalized scripts improve relevance to participants’ histories without making a laboratory response interchangeable with a clinical relapse event.

Related analysis: the cocaine-craving and relapse findings.

Research cited

Mongeau-Pérusse and colleagues (2021). Cannabidiol as a treatment for craving and relapse in individuals with cocaine use disorder: a randomized placebo-controlled trial. DOI: 10.1111/add.15417.