Responders and nonresponders in addiction treatment: Real-time daily-life stress reactivity differs more than trait coping

Tuesday, September 23, 2014 — Poster Session III
12:00 p.m. – 2:00 p.m.	FAES Academic Center	NIDA	CLIN-5

* FARE Award Winner

Authors

• M.A. Furnari
• M.L. Jobes
• K.A. Phillips
• D.H. Epstein
• K.L. Preston

Abstract

We used an ecological momentary assessment (EMA) approach to study drug use and stressful events during methadone maintenance. For 16 weeks participants in methadone maintenance used PDAs as electronic diaries (EDs) to complete 3 randomly prompted (RP) entries per day and to initiate event-contingent (EC) entries when they used drugs or felt stressed. Participants were classified as responders or nonresponders (used opioids on < or ≥50% of weeks) based on urine drug screens and self-reports. RP and EC data were then compared between the two groups using multilevel models. Despite few differences in trait-level coping, and no difference in number of daily-life stressors encountered, the nonresponders rated stressors as more severe (reffect = 0.22, CL95 0.02¬–0.40) and reported higher perceived stress (reffect = 0.27, CL95 0.08–0.45) and hassles (reffect = 0.41, CL95 0.23–0.56) in “end of day” EMA entries. Nonresponders also reported greater heroin craving (reffect = 0.25, CL95 0.05–0.43) and cocaine craving (reffect = 0.59, CL95 0.44–0.71), particularly when their stress ratings were highest. Real-time field assessments of stress reactivity can distinguish addiction-treatment responders from nonresponders more sensitively than trait measures. Nonresponders might benefit from additional interventions aimed at reducing daily-life stress reactivity.

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