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Psychopharmacology

, Volume 211, Issue 2, pp 223–232 | Cite as

Daily life hour by hour, with and without cocaine: an ecological momentary assessment study

  • David H. EpsteinEmail author
  • Kenzie L. Preston
Original Investigation

Abstract

Rationale

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.

Objective

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.

Methods

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).

Results

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.

Conclusions

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.

Keywords

Cocaine Abstinence Addiction Behavior Human Ecological momentary assessment 

Notes

Acknowledgments

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.

Funding/support

This research was supported by the NIDA Intramural Research Program.

Supplementary material

213_2010_1884_Fig6_ESM.jpg (448 kb)
Figure S1

Left panels: time course of responses to the multiple-choice question “Who were you with when the beep occurred?” from 6 A.M. to 12 P.M. in 112 participants during periods of cocaine use or abstinence. These panels are identical to the figures in the main paper. Right panels: same data from the subset of 34 participants who contributed data to both the “abstinence” line and the “use” line (JPEG 448 kb)

213_2010_1884_MOESM1_ESM.eps (1.4 mb)
High resolution image file (EPS 1425 kb)
213_2010_1884_Fig7_ESM.jpg (375 kb)
Figure S2

Time course of responses to the multiple-choice question “Where were you when the beep occurred?” Details are the same as for Figure S1 (JPEG 374 kb)

213_2010_1884_MOESM2_ESM.eps (1.3 mb)
High resolution image file (EPS 1308 kb)
213_2010_1884_Fig8_ESM.jpg (530 kb)
Figure S3

Time course of responses to the multiple-choice question “What were you doing when the beep occurred?” Details are the same as for Figure S1 (JPEG 530 kb)

213_2010_1884_MOESM3_ESM.eps (1.6 mb)
High resolution image file (EPS 1618 kb)
213_2010_1884_Fig9_ESM.jpg (559 kb)
Figure S4

Time course of responses to yes/no questions beginning “During the past hour...” and assessing putative triggers of drug craving/use. Details are the same as for Figure S1 (JPEG 558 kb)

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High resolution image file (EPS 1599 kb)
213_2010_1884_Fig10_ESM.jpg (286 kb)
Figure S5

Time course of responses to Likert-scale questions beginning “Right now, do you feel...?” Details are the same as for Figure S1 (JPEG 286 kb)

213_2010_1884_MOESM5_ESM.eps (1.2 mb)
High resolution image file (EPS 1195 kb)

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Copyright information

© US Government 2010

Authors and Affiliations

  1. 1.Treatment Section, Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of HealthDepartment of Health & Human ServicesBaltimoreUSA

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