Relationship between depression on cocaine craving over time amongst patients in a trial evaluating the use of buprenorphine on cocaine use.

AIMS: This study aimed to examine within and between effects of the relationship between depression, using the Beck Depression Inventory (BDI), and cocaine craving, using the visual analog craving scale (VAS), over time.

METHODS

Data from the NIDA Clinical Trial Network Study Cocaine Use Reduction with Buprenorphine (CTN-0048) were used in a secondary analysis (CTN-0148). Random-effects regression modelling was used to examine relationships between participants' depressive symptoms and their cocaine craving over time.

RESULTS

A total of 301 participants with past-year DSM-IV criteria for cocaine and opioid use disorder were analyzed (21.6% female, 10.3% Hispanic, 66.4% Black) being treated with placebo or buprenorphine + naloxone. Craving significantly decreased over time (B = -1.11, 95% CI [-1.21, -1.02], p < 0.001). Depression emerged as a significant within-person predictor of craving over time (B = 0.93, 95% CI [0.76, 1.09], p < 0.001), indicating that when a person's BDI score increased by one point from their own mean, their craving increased by 0.71 units. Between-person differences in average BDI did not have significant effects (p > 0.05), indicating that depression scores across participants did not significantly predict differences in craving.

CONCLUSIONS

These findings highlight depression as a dynamic, time-varying clinical marker of heightened craving risk and suggest that monitoring and addressing increases in depressive symptoms during treatment may help mitigate craving spikes and potentially reduce vulnerability in returning to use.