Laboratory-based assessment of alcohol craving in social drinkers

Subjective feelings of craving for drugs and alcohol are hallmark symptoms of substance abuse and dependence, and they are thought to play a pivotal role in relapse to drug use. However, relatively little is known about the relationship between craving and overt drug-seeking behavior or drug consumption. One way to investigate the relationship between self-report measures of craving and objective measures of drug-taking behavior is to investigate the degree to which they co-vary in laboratory studies. In particular it may be informative to examine the degree to which these measures co-vary after experimental manipulations that are expected to increase or decrease craving for, or use of, a drug. We review the results of several laboratory studies in which both self-report measures of craving or desire for alcohol and alcohol consumption were measured, using subjects who were non-problem social drinkers. The experimental manipulation used to increase craving and drug-taking was the administration of a priming dose of alcohol. The manipulation that was intended to decrease craving and drug-taking was administration of a dose of naltrexone, because of its use in the treatment for alcoholism. In most of these studies, self-reported ratings of desire for alcohol were positively associated with consumption of alcohol. However, there were also instances in which one measure varied independently of the other, indicating that under certain circumstances they are controlled by separate factors. Laboratory-based studies such as these may improve our understanding of how subjective reports of alcohol craving are related to objective measures of consumption.