Recurrent detoxification may elevate alcohol craving as measured by the Obsessive Compulsive Drinking scale

Research has demonstrated a relationship between the number of previous alcohol detoxifications and increased severity of the alcohol withdrawal syndrome (AWS) that is hypothesized to be similar to an electrophysiologic “kindling process.” Application of a “kindling” model to AWS suggests that neuro...

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Bibliographic Details
Published in:Alcohol 2000-02, Vol.20 (2), p.181-185
Main Authors: Malcolm, Robert, Herron, Janice E, Anton, Raymond F, Roberts, James, Moore, Juliann
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult
Adult and adolescent clinical studies
Alcohol Drinking - psychology
Alcohol withdrawal syndrome
Alcoholism
Alcoholism - psychology
Alcoholism - rehabilitation
Alcoholism and acute alcohol poisoning
Biological and medical sciences
Craving
Female
Humans
Kindling hypothesis
Kindling, Neurologic - physiology
Male
Medical sciences
Obsessive compulsive drinking scale
Obsessive-Compulsive Disorder - psychology
Psychiatric Status Rating Scales
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Recurrence
Recurrent detoxification
Substance Withdrawal Syndrome - psychology
Toxicology
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Summary:Research has demonstrated a relationship between the number of previous alcohol detoxifications and increased severity of the alcohol withdrawal syndrome (AWS) that is hypothesized to be similar to an electrophysiologic “kindling process.” Application of a “kindling” model to AWS suggests that neuroadaptation of the central nervous system to repeated detoxifications may also cause neurobehavioral alterations that may affect “craving.” This study examined craving as assessed by the Obsessive Compulsive Drinking Scale (OCDS) in 67 adult outpatients meeting DSM-IV criteria (American Psychiatric Association, 1994) for alcohol dependence and AWS having either < 2 and ⩾ 2 previous detoxifications. Results of ANCOVA revealed that patients with ⩾ 2 previous detoxifications had higher scores on a scale that measures obsessive thoughts about alcohol, drinking urges and behaviors, and a composite of these scores after controlling for alcohol dependence severity, depressive symptoms and number of drinks 2 weeks prior to the study. Findings emphasize the need to address craving and other psychological variables with respect to treatment of AWS.
ISSN:0741-8329
1873-6823
DOI:10.1016/S0741-8329(99)00073-7