Association between a brief alcohol craving measure and drinking in the following week.

BACKGROUND AND AIMS: Craving for alcohol is thought to be a predictor of alcohol use, particularly in the near future. The assessment of craving in clinical practice requires brief, simple measures that can be implemented routinely. This study tested whether greater alcohol craving was associated with a higher likelihood of alcohol use in the subsequent week.

DESIGN

The COMBINE Study (Combining Medications and Behavioral Interventions for Alcohol Dependence) was a large, multi-site clinical trial of treatment for alcohol dependence. Participants were randomized (stratified by site) to one of nine treatment conditions involving combinations of pharmacotherapy and psychotherapy. Craving was assessed every other week throughout the treatment period.

SETTING

Substance use disorder treatment settings at 11 academic sites across the United States.

PARTICIPANTS

Participants from the COMBINE Study (n = 1370) with available craving data.

MEASUREMENTS: Craving was assessed using the three-item self-report Craving Scale. Drinking was assessed using the Timeline Followback method, and was defined as alcohol use in each study week.

FINDINGS: There was an average of 5.8 (of a possible seven) observation pairs per participant. Craving was associated strongly with alcohol use in the following week [B = 0.27, standard error (SEB ) = 0.06, Wald χ(2)  = 43.34, odds ratio (OR) = 1.31, 95% confidence interval (CI) = 1.16, 1.47, P < 0.001]. For each 1-unit increase in the Craving Scale, the likelihood of drinking in the next week was 31% higher.

CONCLUSIONS

Craving for alcohol is associated strongly with alcohol use in the following week. Clinicians can measure alcohol craving effectively using a brief self-report craving scale.