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Mechanisms of Alcohol Craving and Their Clinical Implications

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Recent Developments in Alcoholism

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 14))

Abstract

Craving for alcohol is frequently given as a reason for drinking and is often used as a surrogate measure in studies of alcoholism and its treatment. Despite this wide use, there is little consensus on what craving for alcohol means, the best way to measure it, what mechanism accounts for the urge to drink, or what is its true relationship to alcohol use. This chapter reviews theoretical and measurement issues about the possible mechanisms involved in craving for alcohol and the clinical implications of evidence supporting them. Until recently, most instruments for assessing craving assumed it was a univariate construct and usually contained only one or a few items. Several multi-item and multidimensional rating instruments have now been developed that offer the promise of more useful assessment of clinically relevant behavior. Most models of craving have assumed that a consistent and positive relationship exists between craving and drinking. The incentive sensitization model and the cognitive theory of dr ug use and drug urges may account better than the older models for the frequent clinical observation of a dissociation between craving and drinking. However, no single model or theory of craving accounts for the wide variation in findings reviewed here, suggesting that multiple mechanisms may be involved. A comprehensive, multidisciplinary approach is necessary to elucidate the nature of craving for alcohol and its implications for pharmacological and psychosocial treatment of alcoholism.

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Authors and Affiliations

  1. Behavior Therapy Treatment Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21224

    Edward G. Singleton

  2. Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, 21224

    David A. Gorelick

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  1. Edward G. Singleton
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  2. David A. Gorelick
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© 1998 Kluwer Academic Publishers

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Singleton, E.G., Gorelick, D.A. (1998). Mechanisms of Alcohol Craving and Their Clinical Implications. In: Recent Developments in Alcoholism. Recent Developments in Alcoholism, vol 14. Springer, Boston, MA. https://doi.org/10.1007/0-306-47148-5_8

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  • DOI: https://doi.org/10.1007/0-306-47148-5_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-45747-0

  • Online ISBN: 978-0-306-47148-3

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