Early zyx Prediction of initiation of Abstinence From Cocaine zy Use of a Craving Questionnaire Roger D. Weiss, M.D., Margaret L. Griffin, Ph.D., Cathryn Hufford, zyxwv B.A., Larry R. Muenz, Ph.D., Lisa M. Najavits, Ph.D., Stephanie B. Jansson, B.A., Julia Kogan, M.Ed., Heather J. Thompson, B.A. zyxw me authors administered afive-item craving questionnaire daily to zyxwv 86 outpatients to determine whether initial craving scores predicted the likelihood of initiation of abstinence within a 3O-daype~iod. Patients with higher mean craving scores during.tbe first zyxwv 3 days of the study were less likely to initiate abstinence. However the reIationshipbetween crav- ing and abstinence initiation was not linear. Rather, pa- tients in the top quartile of craving scores were signifcantIy Iess Iikefy to abstain than were patients in the Iower three quartiIes. The findings suggest that this rapid, easily admin- istered craving questionnaire may have short-termpredic- tive validity. (Am J Addict 1997; 6:224-231) lthough the term “craving” is fre- A quently used in the drug dependence literature and in clinical settings, the usefulness and even the meaning of the concept remain controversial. Some re- searchers and clinicians view craving as a critical indicator zyxwvu of clinical status and an important treatment outcome measure in itself,’ whereas others view craving as a tautological concept that retrospectively rationalizes drug use or its absence.z4 According to the latter view, the strength of drug craving is measured by its outcome; that is, an individual who has used drugs, by definition, had stronger craving than someone who has abstained. On the other hand, craving has been correlated with cer- tain more objective measures, such as dose of stimulant administered in the labora- zy t01-y;~ this correlation helps to support the validity of the concept of craving as distinct hom drug use. One potentially important advantage of measuring craving is pragmatic: it is ReceivedApril 29.1996; revised August 18,1996;acceptedNovember 21,1996. From the Alcohol and DrugAbuse zy Program, Mckan Hospital,Belmont, MA. Address correspondence to Dr. Wed, McLean Hospital, 115 Mill Street, Belmont, MA 02178; e-mail:rdwss@aol.com Copyright 0 1997 The American Academy of Addiction Psychiatry. 224 VOLUME 6 NUMBER 3 SUMMER 1997