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Physiologic and Cognitive Changes That Accompany Cocaine Craving in Adolescents

Kilgus, Mark D. MD, PhD*; Pumariega, Andres J. MD; Rea, William S. MD*

Addictive Disorders & Their Treatment: September 2009 - Volume 8 - Issue 3 - p 128-137
doi: 10.1097/ADT.0b013e3181825a1b
Original Articles

Objectives Cocaine use and the recurrence of addiction are significant problems in the US adolescent population. The present study investigated physiologic, affective, and cognitive correlates of cocaine craving in adolescents including elicitation of craving through videotaped cues.

Methods Thirty-two adolescents, ages 14 to 17 years, hospitalized in a drug treatment program, viewed 36 minutes of a videotape which presented salient cocaine cues (eg, paraphernalia, cooking crack, street interviews). Prevideotape and postvideotape measures included: (1) 20-cm analog measures of craving, mood, energy, and wellness, (2) a semantic differential measure of attitudes and cognitive shifts accompanying craving, (3) baseline and continuous measures of pulse pressure, heart rate, muscle tension, and skin temperature to evaluate concomitants to craving and to subsequent desensitization while observing a nature videotape.

Results Exposure to audiovisual cues significantly increased craving in 25 of the 32 subjects. Video-presented cocaine cues were associated with decreased pulse pressure and increased skin temperature. A reversal of physical changes occurred in response to the nature scenes videotape as pulse pressure increased and heart rate decreased. Changes in craving were also significantly correlated with changes in energy, sense of well-being, and cognition.

Conclusions Cocaine craving is demonstrated to occur in adolescents, induced by audiovisual cues, and accompanied by affective, physiologic, and cognitive changes. These findings may have important implications for clinical treatment and research.

*Carilion Clinic, Department of Psychiatry and Behavioral Medicine, Roanoke, VA

Department of Psychiatry, The Reading Hospital and Medical Center, Reading PA

Supported by a grant from the South Carolina Department of Mental Health (SCDMH) through the William S. Hall Psychiatric Institute, Columbia, SC. The Institutional Review Board of the SCDMH approved and provided oversight of this project.

Reprints: Mark D. Kilgus, MD, PhD, Department of Psychiatry and Behavioral Medicine, Carilion Clinic, 1st Floor Administrative Suite, 2017 Jefferson Avenue, Roanoke, VA 24014 (e-mail:

The authors have no financial relationships to disclose.

© 2009 Lippincott Williams & Wilkins, Inc.