Abstract：
OBJECTIVE: The aim of this study was to measure trajectories of craving for methamphetamine during the course of pharmacotherapy trials for methamphetamine use disorder.
METHODS: Craving trajectories were identified using Group-Based Trajectory Modeling. The association of craving trajectories with drug use trajectories was examined using a dual trajectory model. Association of craving trajectories with other health and social outcomes was also examined. The study used pooled data from five randomized controlled pharmacotherapy trials for methamphetamine use disorder. A total of 866 adults with methamphetamine use disorder participated in randomized controlled pharmacotherapy trials.
METHODS: Craving was assessed weekly using the Brief Substance Craving Scale. Drug use was assessed using urine toxicology. Alcohol- and drug-related problems, as well as psychiatric, medical, legal, employment and relationship problems, were measured using the Addiction Severity Index.
RESULTS: A three-trajectory model with high, medium and low craving trajectories was selected as the most parsimonious model. Craving trajectories were associated with methamphetamine use trajectories in the course of trial; 88.4% of those in the high craving trajectory group had a consistently high frequency of methamphetamine use compared with 18.7% of those in the low craving group. High craving was also associated with less improvement in most other outcomes and higher rate of dropout from treatment. In turn, low craving was associated with a rapidly decreasing frequency of methamphetamine use, greater improvement in most other outcomes and a lower rate of dropout. Participants on modafinil daily and ondansetron 1 mg twice daily were less likely to be in the high craving group compared with those on placebo.
CONCLUSIONS: Trajectories of methamphetamine craving in the course of clinical trials for methamphetamine use disorder appear to be both highly variable and strongly associated with greater frequency of drug use, other drug-related outcomes and dropout from trials. Two medications, modafinil daily and ondansetron at a dose of 1 mg two times daily, appear to be associated with greater reduction in craving in the course of treatment compared with placebo. A decrease in methamphetamine craving shows promise as an early indicator of recovery from methamphetamine use disorder.
METHODS: Craving trajectories were identified using Group-Based Trajectory Modeling. The association of craving trajectories with drug use trajectories was examined using a dual trajectory model. Association of craving trajectories with other health and social outcomes was also examined. The study used pooled data from five randomized controlled pharmacotherapy trials for methamphetamine use disorder. A total of 866 adults with methamphetamine use disorder participated in randomized controlled pharmacotherapy trials.
METHODS: Craving was assessed weekly using the Brief Substance Craving Scale. Drug use was assessed using urine toxicology. Alcohol- and drug-related problems, as well as psychiatric, medical, legal, employment and relationship problems, were measured using the Addiction Severity Index.
RESULTS: A three-trajectory model with high, medium and low craving trajectories was selected as the most parsimonious model. Craving trajectories were associated with methamphetamine use trajectories in the course of trial; 88.4% of those in the high craving trajectory group had a consistently high frequency of methamphetamine use compared with 18.7% of those in the low craving group. High craving was also associated with less improvement in most other outcomes and higher rate of dropout from treatment. In turn, low craving was associated with a rapidly decreasing frequency of methamphetamine use, greater improvement in most other outcomes and a lower rate of dropout. Participants on modafinil daily and ondansetron 1 mg twice daily were less likely to be in the high craving group compared with those on placebo.
CONCLUSIONS: Trajectories of methamphetamine craving in the course of clinical trials for methamphetamine use disorder appear to be both highly variable and strongly associated with greater frequency of drug use, other drug-related outcomes and dropout from trials. Two medications, modafinil daily and ondansetron at a dose of 1 mg two times daily, appear to be associated with greater reduction in craving in the course of treatment compared with placebo. A decrease in methamphetamine craving shows promise as an early indicator of recovery from methamphetamine use disorder.
摘要：
目的：本研究的目的是测量在甲基苯丙胺使用障碍的药物治疗试验过程中对甲基苯丙胺的渴望轨迹。
方法：使用基于组的轨迹建模来识别渴望轨迹。使用双轨迹模型检查了渴望轨迹与药物使用轨迹的关联。还研究了渴望轨迹与其他健康和社会结果的关系。该研究使用了来自五项针对甲基苯丙胺使用障碍的随机对照药物治疗试验的汇总数据。共有866名患有甲基苯丙胺使用障碍的成年人参加了随机对照药物治疗试验。
方法：每周使用简短物质渴望量表评估渴望。使用尿液毒理学评估药物使用情况。与酒精和药物有关的问题，以及精神病学，medical,legal,就业和关系问题，使用成瘾严重程度指数进行测量。
结果：具有高，中、低渴求轨迹被选为最简约的模型。在试验过程中，渴望轨迹与甲基苯丙胺的使用轨迹相关；高渴望轨迹组中有88.4％的人使用甲基苯丙胺的频率一直很高，而低渴望轨迹组中有18.7％的人使用甲基苯丙胺。高渴望也与大多数其他结果的改善和更高的治疗退出率相关。反过来,低渴望与甲基苯丙胺使用频率的迅速下降有关，大多数其他结果的改善更大，辍学率更低。与安慰剂组相比，每天服用莫达非尼和每天两次服用恩丹西酮1mg的参与者在高渴望组中的可能性较小。
结论：在甲基苯丙胺使用障碍的临床试验过程中，甲基苯丙胺渴望的轨迹似乎是高度可变的，并且与更高的药物使用频率密切相关，其他与药物相关的结局和从试验中退出。两种药物,莫达非尼每天和昂丹司琼，剂量为1mg，每天两次，与安慰剂相比，似乎与治疗过程中的渴望减少有关。甲基苯丙胺渴望的减少显示出有望从甲基苯丙胺使用障碍中恢复的早期指标。
方法：使用基于组的轨迹建模来识别渴望轨迹。使用双轨迹模型检查了渴望轨迹与药物使用轨迹的关联。还研究了渴望轨迹与其他健康和社会结果的关系。该研究使用了来自五项针对甲基苯丙胺使用障碍的随机对照药物治疗试验的汇总数据。共有866名患有甲基苯丙胺使用障碍的成年人参加了随机对照药物治疗试验。
方法：每周使用简短物质渴望量表评估渴望。使用尿液毒理学评估药物使用情况。与酒精和药物有关的问题，以及精神病学，medical,legal,就业和关系问题，使用成瘾严重程度指数进行测量。
结果：具有高，中、低渴求轨迹被选为最简约的模型。在试验过程中，渴望轨迹与甲基苯丙胺的使用轨迹相关；高渴望轨迹组中有88.4％的人使用甲基苯丙胺的频率一直很高，而低渴望轨迹组中有18.7％的人使用甲基苯丙胺。高渴望也与大多数其他结果的改善和更高的治疗退出率相关。反过来,低渴望与甲基苯丙胺使用频率的迅速下降有关，大多数其他结果的改善更大，辍学率更低。与安慰剂组相比，每天服用莫达非尼和每天两次服用恩丹西酮1mg的参与者在高渴望组中的可能性较小。
结论：在甲基苯丙胺使用障碍的临床试验过程中，甲基苯丙胺渴望的轨迹似乎是高度可变的，并且与更高的药物使用频率密切相关，其他与药物相关的结局和从试验中退出。两种药物,莫达非尼每天和昂丹司琼，剂量为1mg，每天两次，与安慰剂相比，似乎与治疗过程中的渴望减少有关。甲基苯丙胺渴望的减少显示出有望从甲基苯丙胺使用障碍中恢复的早期指标。
