Link Between Perception of Treatment Need and Craving Reports in Addiction.

Laura Lambert,Berangere Thirioux,Perrine Roux,Nematollah Jaafari,Fuschia Serre,Jean-Pierre Daulouède,Laurence Lalanne,Marc Auriacombe,Marie Jauffret-Roustide

doi:10.3389/fpsyt.2021.790203

Abstract

BackgroundPerception of treatment need (PTN), a component of clinical insight, is associated to negative addiction treatment outcomes when low. Our hypothesis was that lower PTN was associated with less craving when reported retrospectively, the most common measure of craving in clinical settings.ObjectiveTo explore the association between PTN and craving among a dataset of subjects with severe substance use disorders.MethodsParticipants were recruited from outpatient addiction clinic admissions or harm reduction program services. Good and low PTN were based on consistency between severe addiction (at least six DSM-5 criteria) and self-report need for addiction treatment from the Addiction Severity Index. Craving was retrospectively characterized over the past 30 days. Multiple regression analyses were conducted.ResultsParticipants with low PTN (n = 97) retrospectively reported less frequent and intense episodes of craving, compared with participants with good PTN (n = 566) after controlling for sociodemographic factors, addiction type, and severity (p < 0.0001).ConclusionLow perception of treatment need among subjects with severe addictions is associated to less retrospective report of craving, which may contribute to reduced efficiency of treatment. Further studies are needed to explore the mechanisms of the association.

Highlights

Addiction is characterized by an impaired control over use of reinforcing substances or behaviors and repeated relapses after attempts to stop [1, 2]
We examined the correlation between perception of treatment need and craving, self-reported retrospectively, among subjects with a severe addiction, and controlling for addiction and subject characteristics
Perception of treatment need (PTN) status was modeled as the consistency between objective addiction severity and the Addiction Severity Index (ASI) self-report of the need for addiction treatment by participants

Summary

Introduction

Addiction is characterized by an impaired control over use of reinforcing substances or behaviors and repeated relapses after attempts to stop [1, 2]. Craving is reported as transient, intrusive, and unwanted experiences of urges for use of a substance or an addictive behavior [1, 3]. Lack of perceived treatment need has been documented among adults with substance use disorders (SUD) [14]. Perception of treatment need (PTN) is one of the three subdimensions of clinical insight according to the David model [15, 16]. Clinical insight is the capability to recognize one’s mental illness, to recognize its symptoms and consequences, to perceive need for treatment, and to consent to medical care [for review see [17, 18]]. Perception of treatment need (PTN), a component of clinical insight, is associated to negative addiction treatment outcomes when low. Our hypothesis was that lower PTN was associated with less craving when reported retrospectively, the most common measure of craving in clinical settings

Methods

Results

Discussion

Conclusion