Craving by imagery cue reactivity in opiate dependence following detoxification

BACKGROUND: Frequent relapses in opioid addiction may be a result of abstinentemergent craving. Exposure to various stimuli associated with drug use (drug cues) may trigger craving as a conditioned response to ′drug cues′. AIMS: The present study explored the effects of imagery cue exposure on psychophysiological mechanisms of craving, viz. autonomic arousal, in detoxified opiate addicts. METHODOLOGY: Opiate dependent subjects (N=38) following detoxification underwent imagery cue reactivity trials.The subjects were asked to describe verbally and then imagine their craving experiences. RESULTS: Craving was measured subjectively by using Visual Analogue Scale and autonomic parameters of galvanic skin resistance (GSR), pulse rate (PR), and skin temperature (ST) was taken during cue imagery. Spearman′s r and Wilcoxon signed ranks test were employed in analysis. Multivariate repeated measurement analysis (wilk′s Lambda) was employed wherever appropriate. Subjective measures of craving, GSR and PR increased significantly whereas ST decreased significantly during drug related cue imagery as compared to neutral cues. CONCLUSIONS: The results support that cue imagery is a powerful tool in eliciting craving. Hence, it can be used as a screening manoeuvre for detecting individuals with high cue reactivity, as well as for extinction of craving.