Understanding Substance Cravings


By Topher Avery

Original Source: addictionnow.com

Substance use disorder is recognized as a brain disease, characterized by persistent drug-seeking behavior in spite of negative consequences. A primary component of ongoing substance abuse are cravings experienced by the individual. While they play an integral role in drug addiction, cravings are not as well understood as they might be, and a recent report argues that a better understanding of cravings could lead to more effective substance abuse treatments.

Craving is one of the primary driving forces behind substance abuse and was even considered as an element of the diagnostic criteria for substance abuse in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but a lack of consensus on the nature of craving meant it couldn’t be included. Craving is commonly understood to be a subjective state in which an individual undergoes an extraordinary urge to engage in a particular behavior, regardless of whether or not that behavior includes detrimental consequences. A recent report on craving, released in December 2016 by the journal Progress in Brain Research, explained that modern theorists have recognized this subjective state to be just one element of craving.

According to the report, craving is better understood to be a variety of phenomena. These include the memories a person has of past substance use, difficulty focusing on things other than the craving, a heightened attention to substance-related stimuli (such as the sound of two beer mugs clanking together or the sight of a hypodermic needle), and the expectancy the person has as the result of substance abuse. In addition, cravings may also be associated with the desire to mitigate the symptoms of withdrawal, which may occur upon cessation of substance use.

Unfortunately, this limited understanding of the phenomenon of craving has led to some problems in the efficacy of addiction recovery treatment, since many types of intervention target certain aspects of craving while leaving other elements intact. These untreated elements can then lead the individual back to substance abuse in order to satiate the remaining aspects of craving. A better understanding of the complex nature of craving, the report argues, will lead to…

complementary intervention techniques that can be combined to provide an addicted person with more comprehensive protection against relapse.

Currently, there are two primary perspectives that put forward separate models for understanding craving. The conditioning perspective suggests that craving is a Pavlovian response, formed by a continued pairing of stimulus (in this case, substance use) with perceived positive effects (such as the pleasure or relief an individual experience after consuming a substance).

By contrast, the cognitive perspective posits that craving is the result of a variety of concurrent mental processes that occur due to a substance cue (such as smelling one’s substance of choice). However, neither of these models provided a complete understanding of the craving phenomenon.

As technology advances, some experts are eager to utilize cutting-edge neuroscience to provide a basis for updating current models of understand craving in order to improve treatment, such as using neuroimaging techniques to determine the neural correlates of craving – in other words, to see how the mechanisms of the brain behave when an individual is experiencing a craving. Scientists are hopeful that a better understanding of these cognitive functions will result in more effective treatments for craving.

Ultimately, the report argues that by utilizing new technology and integrating the existing models of understanding craving, a better comprehension of this driving element of addiction can be achieved. Through a deeper grasp of addiction, more efficient intervention techniques to mitigate the experience of craving can be developed, leading to more effective addiction recovery treatments.

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