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Effects of Alcohol Cue Reactivity on Subsequent Treatment Outcomes Among Treatment‐Seeking Individuals with Alcohol Use Disorder: A Multisite Randomized, Double‐Blind, Placebo‐Controlled Clinical Trial of Varenicline
Author(s) -
Miranda Robert,
O’Malley Stephanie S.,
Treloar Padovano Hayley,
Wu Ran,
Falk Daniel E.,
Ryan Megan L.,
Fertig Joanne B.,
Chun Thomas H.,
Muvvala Srinivas B.,
Litten Raye Z.
Publication year - 2020
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.14352
Subject(s) - craving , varenicline , cue reactivity , placebo , alcohol use disorder , randomized controlled trial , context (archaeology) , psychology , alcohol , psychiatry , medicine , clinical psychology , nicotine , addiction , chemistry , biochemistry , alternative medicine , pathology , paleontology , biology
Background The alcohol cue reactivity paradigm is increasingly used to screen medications for the treatment of alcohol use disorder (AUD) and other substance use disorders. Yet, its prospective association with craving and naturalistic drinking outcomes in clinical trials remains unknown. This study embedded repeated human laboratory assessments of alcohol cue reactivity within the context of a randomized controlled trial to examine the effects of varenicline tartrate (Chantix ® ), a partial agonist of α4β2 nicotinic acetylcholine receptors, on alcohol craving among treatment‐seeking heavy drinkers with AUD. Our main objectives were to test whether varenicline, as compared to placebo, blunts alcohol cue–elicited craving and test whether alcohol cue reactivity observed in the human laboratory predicts subsequent alcohol craving and use during the remainder of the trial. Design and Methods This double‐blind, randomized, 2‐site study compared the effects of varenicline (up to 2 mg/d) and placebo on responses to in vivo alcohol cue and affective picture cue exposure in the human laboratory. Forty‐seven volunteers (18 females, 29 males), ages 23 to 67 years ( M = 43.7, SD = 11.5), were recruited from the community via advertisements to participate in a clinical trial designed to study the effects of varenicline on alcohol use. Participants were randomized to either varenicline or placebo for 6 weeks. Results Varenicline did not attenuate cue‐induced alcohol craving relative to placebo, but craving captured during the cue reactivity paradigm significantly predicted subsequent alcohol use in real‐world settings during the clinical trial. Higher craving predicted heavier alcohol use. Conclusions Our results are among the first to show alcohol cue–induced craving captured during a human laboratory paradigm predicts drinking outcomes in the context of a clinical trial.