Recurrent detoxification may elevate alcohol craving as measured by the Obsessive Compulsive Drinking scale

Area of Science:

• Neuroscience
• Psychiatry
• Addiction Medicine

Background:

• Repeated alcohol detoxification is linked to increased alcohol withdrawal syndrome (AWS) severity.
• This phenomenon is hypothesized to involve an electrophysiologic "kindling process" in the central nervous system.
• Neuroadaptation from repeated detoxifications may lead to neurobehavioral changes affecting craving.

Purpose of the Study:

• To investigate the relationship between the number of previous alcohol detoxifications and craving.
• To assess craving using the Obsessive Compulsive Drinking Scale (OCDS) in adult outpatients with alcohol dependence and AWS.

Main Methods:

• Sixty-seven adult outpatients meeting DSM-IV criteria for alcohol dependence and AWS were studied.
• Participants were divided into groups based on having fewer than 2 or 2 or more previous detoxifications.
• Analysis of Covariance (ANCOVA) was used to compare craving scores, controlling for covariates.

Main Results:

• Patients with 2 or more previous detoxifications exhibited significantly higher OCDS scores.
• This included elevated scores for obsessive thoughts about alcohol, drinking urges, and behaviors.
• These findings persisted after controlling for alcohol dependence severity, depressive symptoms, and recent alcohol consumption.

Conclusions:

• The number of previous alcohol detoxifications is associated with increased craving.
• The "kindling" model may explain neurobehavioral alterations contributing to craving after repeated detoxification.
• Treatment for AWS should consider addressing craving and other psychological variables.