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Updated: May 26, 2026

A Protocol for Measuring Cue Reactivity in a Rat Model of Cocaine Use Disorder
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Stimulant Craving and Drug Use Dynamics: A Cross-Lagged Residual Dynamic Structural Equation Modeling Study.

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    Stimulant craving and drug use dynamically interact, with each influencing the other over time. This bidirectional relationship and its variability may impact treatment effectiveness for stimulant use disorders.

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    Area of Science:

    • Addiction research
    • Psychopharmacology
    • Clinical psychology

    Background:

    • Stimulant use disorders (SUDs) are a significant public health concern.
    • Understanding the dynamic interplay between craving and drug use is crucial for effective treatment.
    • Pharmacotherapies are a key component in managing SUDs, but individual responses vary.

    Purpose of the Study:

    • To investigate the longitudinal, dynamic interactions between craving and drug use during SUD treatment.
    • To determine the reciprocal (bidirectional) associations between craving and stimulant drug use over time.
    • To explore how individual differences in this interaction might explain treatment response variability.

    Main Methods:

    • Utilized pooled data from 11 randomized controlled trials (RCTs) of pharmacotherapies for methamphetamine and cocaine use disorders.
    • Employed cross-lagged residual dynamic structural equation modeling (R-DSEM) to analyze longitudinal associations.
    • Measured craving using the Brief Substance Craving Scale (BSCS) and drug use via Timeline Followback and urine drug screens (UDS).

    Main Results:

    • A significant bidirectional relationship was found between craving and stimulant drug use.
    • Daily craving predicted subsequent drug use (self-reported and UDS-verified).
    • Drug use also predicted subsequent craving, with substantial between-person heterogeneity observed in these effects.

    Conclusions:

    • Stimulant craving and drug use exhibit a dynamic, bidirectional interaction.
    • The heterogeneity in this interaction may partially explain individual differences in response to anti-craving medications for SUDs.
    • These findings highlight the importance of considering the dynamic interplay of craving and use in personalized SUD treatment approaches.