June 24, 2010 Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery, according to behavioral researchers.
"Cravings are a strong predictor of relapse," said H. Harrington Cleveland, associate professor of human development, Penn State. "The goal of this study is to predict the variation in substance craving in a person on a within-day basis. Because recovery must be maintained 'one day at a time,' researchers have to understand it on the same daily level."
Cleveland and his colleague Kitty S. Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, used data from a daily diary study of college students who are recovering addicts to identify the processes that trigger cravings and prevent some addicts from building a sustained recovery.
The researchers found that how addicts cope with stress -- either by working through a problem or avoiding it -- is a strong predictor of whether they will experience cravings when faced with stress and negative mood.
"Whether you avoid problems or analyze problems not only makes a big difference in your life but also has a powerful impact on someone who has worked hard to stay away from alcohol and other drugs," explained Cleveland. "When faced with stress, addicts who have more adaptive coping skills appear to have a better chance of staying in recovery." The findings appeared in a recent issue of Addictive Behaviors.
Researchers supplied Palm Pilots to 55 college students who were in recovery from substance abuse ranging from alcohol to cocaine and club drugs. The students were asked to record the their daily cravings for alcohol and other drugs, as well as the intensity of negative social experiences -- hostility, insensitivity, interference, and ridicule -- and their general strategies for coping with stress.
"We looked at variations in the number of cravings across days and found that these variations are predicted by stressful experiences," said Cleveland. "More importantly, we found that the strength of the daily link between experiencing stress and the level of cravings experienced is related to the participants' reliance on avoidance coping."
Statistical analyses of the survey data suggests that the magnitude of the link between having a stressful day and experiencing substance use cravings doubles for recovering addicts who cope with stress by avoiding it.
"We found that addicts who deal with stress by avoiding it have twice the number of cravings in a stressful day compared to persons who use problem solving strategies to understand and deal with the stress," explained Cleveland. "Avoidance coping appears to undercut a person's ability to deal with stress and exposes that person to variations in craving that could impact recovery from addiction."
According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.
"If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems," he added.
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- H. Harrington Cleveland, Kitty S. Harris. The role of coping in moderating within-day associations between negative triggers and substance use cravings: A daily diary investigation. Addictive Behaviors, 2010; 35 (1): 60 DOI: 10.1016/j.addbeh.2009.08.010
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