Daily life hour by hour, with and without cocaine: an ecological momentary assessment study
- 278 Downloads
Effects of an intervention cannot be understood without precise knowledge of the baseline behavior on which the intervention is superimposed. For misusers of illicit drugs, patterns of daily activities and moods have not been studied in a way that is amenable to statistical aggregation.
The aim of the study was to compare hour-by-hour daily activities in cocaine-dependent outpatients during urine-verified periods of use and abstinence.
In a cohort design, a volunteer sample of 112 methadone-maintained cocaine- and heroin-abusing outpatients provided ecological momentary assessment (EMA) data on handheld computers for 10,781 person-days. EMA responses to questions about current location, activities, companions, moods, and recent exposure to putative drug-use triggers were compared across periods of use and abstinence using SAS Proc Glimmix (for binary outcomes) and Proc Mixed (for continuous outcomes).
Periods of cocaine use were associated with idle, solitary, affectively negative afternoons but, unexpectedly, were also associated with a greater likelihood of early-morning or late-evening work. The whole-day concomitants of cocaine use were often distinct from the acute predecessors of use seen in prior analyses from the same sample. Several measures of negative mood increased during abstinence.
Weeks of cocaine use and abstinence in outpatients are associated with distinct patterns of mood and behavior; the detailed hourly data reported here should help inform treatment interventions aimed at changing daily activities. The findings also argue against the contention that cocaine abstinence symptoms decrease monotonically from the day of cessation.
KeywordsCocaine Abstinence Addiction Behavior Human Ecological momentary assessment
This research was supported the Intramural Research Program (IRP) of the National Institute on Drug Abuse (NIDA), National Institutes of Health. We wish to thank the NIDA IRP Archway Clinic staff for data collection.
This research was supported by the NIDA Intramural Research Program.
- Fox S (2006) Demographics, degrees of Internet access, and health. Presented at Pew Internet & American Life Project meeting (Identifying and Disseminating Best Practices for Health eCommunities), Chapel Hill, NC. http://www.pewinternet.org/∼/media//Files/Presentations/2006/Fox_UNC_June_2006.pdf. Accessed 26 Oct 2009
- Marlatt GA, Gordon JRE (1985) Relapse prevention: maintenance strategies in the treatment of addictive behaviors. Guilford, New YorkGoogle Scholar
- Robins LN, Cottler LB, Bucholz KK, Compton WM III (1995) The diagnostic interview schedule, version IV. Washington University, St. LouisGoogle Scholar
- Sidman M (1960) Tactics of scientific research: evaluating experimental data in psychology. Basic Books, New YorkGoogle Scholar
- Skinner BF (1938) The behavior of organisms: an experimental analysis. Appleton-Century, OxfordGoogle Scholar
- Vahabzadeh M, Epstein DH, Mezghanni M, Lin J-L, Preston KL (2004) An electronic diary software for ecological momentary assessment (EMA) in clinical trials. Proceedings of the 17th IEEE Symposium on Computer-Based Medical Systems (CBMS), pp 167–172Google Scholar
- Waldorf D, Reinarman C, Murphy S (1992) Cocaine changes: the experience of using and quitting. Temple University Press, PhiladelphiaGoogle Scholar