Cited by 133Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

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Assessing craving and its relationship to subsequent prescription opioid use among treatment-seeking prescription opioid dependent patients

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McHugh, R. Kathryn, Fitzmaurice, Garrett M., Carroll, Kathleen M., Griffin, Margaret L., Hill, Kevin P., Wasan, Ajay D., Weiss, Roger D.·2014·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2014.10.002PMC PMC4254575

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Abstract

Background Craving is viewed as a core feature of substance use disorders and has been shown to predict future drug use, particularly over the short term. Accordingly, craving is often assessed in treatment settings as a marker of risk for subsequent drug use. The identification of the briefest measure that maintains predictive validity is of particular value for both clinical and research settings to minimize assessment burden while maintaining utility for the prediction of use.Methods Data from a multi-site clinical trial of treatment for prescription opioid dependence were examined to evaluate whether a brief, 3-item craving scale administered each week predicted urine-confirmed self report of prescription opioid use in the subsequent week. Logistic regression models examining the association between craving and presence or absence of opioid use in the following week were conducted, controlling for opioid use in the previous week, treatment condition, and lifetime history of heroin use.Results Greater craving was associated with a higher odds of prescription opioid use in the following week. For each one-unit increase on this 10-point scale, the odds of using opioids in the subsequent week was 17% higher. In addition to an item assessing urges, items assessing cue-induced craving and perceived likelihood of relapse in an environment where drugs were previously used contributed uniquely to this association.Conclusions A brief measure of prescription opioid craving predicted prescription opioid use among individuals in treatment. This measure offers an efficient strategy to inform the assessment of risk for use in this population.

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Gharbo, R. S. (2020) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2020.07.003 · Cited by 9
The effect of self-compassion training on craving and self-efficacy in female patients with methamphetamine dependence: a one-year follow-up
Abdoli, N., Farnia, V., Radmehr, F., Alikhani, M., Moradinazar, M., Khodamoradi, M., Salemi, S., Rezaei, M., & Davarinejad, O. (2020) · Journal of Substance Use · doi:10.1080/14659891.2020.1851406 · Cited by 8
“Since women exert tremendous effects on various aspects of life, especially family life, their addiction entails harmful consequences for human societies, especially about the family unit and children’s upbringing (McHugh et al., 2014).”
Background
Commentary: Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice
Zheng, R., Liu, H., Li, Y., Zhang, T., Bai, D., Zhang, L., Li, D., & Hao, W. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.615921 · Cited by 8
“Despite the development of several psychometrically validated multi-item craving inventory tools (12, 13), self-reported cravings are still most commonly evaluated using a single item craving inventory (11).”
Method
Dual-Brain Psychology: A novel theory and treatment based on cerebral laterality and psychopathology
Schiffer, F. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.986374 · Cited by 7
“In regard to opioid cravings measured by an opioid craving scale (McHugh et al., 2014), overall, in the active group, there was a 75% decrease in opioid cravings in the actively treated group and a 30% decrease in the sham group.”
Method
Feasibility of Web-Based Single-Session Empowered Relief in Patients With Chronic Pain Taking Methadone or Buprenorphine: Protocol for a Single-Arm Trial
Klein, M. R., Darnall, B. D., & You, D. S. (2024) · JMIR Research Protocols · doi:10.2196/53784 · Cited by 7
“The secondary outcome measures are pain catastrophizing [35], pain intensity [39], pain bothersomeness [38], and sleep disturbance [40] as reported by the patient at the 1-month posttreatment time frame.”
Background
Craving self‐reports as outcome measures in drug addiction trials: A systematic review of ClinicalTrials.gov
Toulami, M., Ghasemi, K., Rafei, P., Sangchooli, A., Nafissi, N., Zonoozi, A. K., Ardabili, H. M., Ebrahimi, M., Rezapour, T., & Ekhtiari, H. (2025) · Addiction · doi:10.1111/add.70064 · Cited by 9
“In terms of multi-item questionnaires, the OCS [54] was more frequently used compared to the DDQ [ 51], the HCQ [69] and the OCDUS [51], which Kleykamp et al .”
Influential
Extended-Release vs Sublingual Buprenorphine in Pregnancy Through 12 Months Post Partum
Winhusen, T. M., Lofwall, M. R., Kropp, F. B., Lewis, D. F., Smid, M. C., Young, J. L., Hodgkins, C. C., Krans, E. E., Hansen, Z., Wachman, E. M., et al. (2026) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2026.0057 · Cited by 9
Association between body mass index and treatment completion in extended-release naltrexone-treated patients with opioid dependence
Li, X., Langleben, D. D., Lynch, K. G., Wang, G., Elman, I., Wiers, C. E., & Shi, Z. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1247961 · Cited by 7
A clinical trial of the Examen and mindfulness within a secular substance use disorder treatment program
Buenrostro, C. M., & Plante, T. G. (2024) · Journal of Addictions & Offender Counseling · doi:10.1002/jaoc.12127 · Cited by 7
“Craving is a foundational aspect of SUDs, and greater cravings are associated with a higher risk for substance use (American Psychiatric Association, 2013; McHugh et al., 2014).”
Influential
Mediating effect of craving on the impact of buprenorphine/naloxone and methadone treatment on opioid use: Results from a randomized controlled trial
McAnulty, C., Bastien, G., Ledjiar, O., Socias, M. E., Foll, B. L., Lim, R., & Jutras‐Aswad, D. (2024) · Addictive Behaviors · doi:10.1016/j.addbeh.2024.108023 · Cited by 7
The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes
MacLean, R. R., Spinola, S., Garcia‐Vassallo, G., & Sofuoglu, M. (2021) · Current Addiction Reports · doi:10.1007/s40429-020-00352-6 · Cited by 7
Psychiatric comorbidity and order of condition onset among patients seeking treatment for chronic pain and opioid use disorder
Barry, D. T., Beitel, M., Cutter, C. J., Fiellin, D. A., Madden, L. M., Lipkind, N., Bollampally, P., Liong, C., & Schottenfeld, R. S. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108608 · Cited by 7
Rationale, design, and methodology of a randomized pilot trial of an integrated intervention combining computerized behavioral therapy and recovery coaching for people with opioid use disorder: The OVERCOME study
Pericot‐Valverde, I., Perez, A., Heo, M., Coleman, A., Ortiz, E. G., Merchant, K., Melling, T., & Litwin, A. H. (2022) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2022.100918 · Cited by 7
“…and confidence to change using two visual analog scales from 0 to 100 [35], any counseling or coaching received and its length, level of craving experienced using the Opioid Craving Scale [36], and the severity of withdrawal symptoms experienced using the Subjective Opiate Withdrawal [37] (week 4).”
Method
Learning from addiction: Craving of prescription opioids in chronic pain sufferers
Strigo, I. A., Murphy, E., Mitchell, J., & Spadoni, A. D. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104904 · Cited by 7
Use of a sequential multiple assignment randomized trial to test contingency management and an integrated behavioral economic and mindfulness intervention for buprenorphine-naloxone medication adherence for opioid use disorder
Peter, S. C., Murphy, J. G., Witkiewitz, K. A., Hand, S. B., Thomas, F., Johnson, K., Cowan, R. L., Harris, M., & Derefinko, K. J. (2023) · Trials · doi:10.1186/s13063-023-07102-9 · Cited by 7
Sleep disruption, stress, and craving during inpatient treatment for opioid use disorder
Bichon, J. A., Bailey, A. J., Votaw, V. R., & McHugh, R. K. (2025) · Addictive Behaviors · doi:10.1016/j.addbeh.2025.108427 · Cited by 6
Self-citation
Associations among interpretation bias, craving, and abstinence self-efficacy in adults with substance use disorders
Beard, C., Peckham, A., Griffin, M. L., Weiss, R. D., Taghian, N. R., & McHugh, R. K. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.107644 · Cited by 6
Self-citation
Design and implementation of a prospective cohort study of persons living with and without HIV infection who are initiating medication treatment for opioid use disorder
Biondi, B. E., Mohanty, S., Wyk, B. V., Montgomery, R. R., Shaw, A. C., & Springer, S. A. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100704 · Cited by 6
‘I crave not to feel uncomfortable’ – investigating craving for opioids and cannabis among individuals with chronic pain
Thrul, J., Nordeck, C. D., Devkota, J., Mun, C. J., Dunn, K. E., Bergeria, C. L., Zipunnikov, V. M., Vandrey, R. G., & Finan, P. H. (2024) · Drugs Education Prevention and Policy · doi:10.1080/09687637.2024.2331572 · Cited by 6
“Craving to use substances is an indicator for problematic substance use, including opioid use in treatment studies for opioid use disorder (OUD) (McHugh et al., 2014), is cited by patients as a primary treatment goal and unmet need in their OUD treatments (FDA Center for Drug Evaluation and Research, 2019), and has be…”
Influential
Characterizing withdrawal from long-acting injectable buprenorphine: An observational case series
Hayes, V., Mills, L., Byron, G., Stubley, C., Black, E., Trevitt, B. T., Somogyi, A. A., Sahid, A. S., & Lintzeris, N. (2025) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2025.100329 · Cited by 5
“• Opioid Craving Scale (OCS; McHugh et al., 2014; weekly): This three-item scale measures opioid cravings on a 0 (no craving) to 10 (severe craving) response scale for each item: (i) at the time the respondent is completing the questionnaire, (ii) over the previous week when the respondent is…”
Validation of Heroin Craving Questionnaire in Greek Patients under Substitution Treatment with Methadone and Buprenorphine: How to Prevent a Relapse
Leventelis, C., Veskoukis, A. S., Malliori, M., Koutsilieris, M., Zyga, S., Gil, A. P. R., Kampitsi, A., Goutzourelas, N., & Tsironi, M. (2020) · doi:10.4172/2324-9005.1000189 · Cited by 5
“Similarly, it has been shown that craving for opioids is a prognostic factor for recurrence in individuals with a record in opioid use disorders [23,24].”
Psychometric properties of the Anxiety Sensitivity Index-3 in adults with substance use disorders
Hilton, B. T., Yusufov, M., Rosellini, A. J., Taghian, N. R., Weiss, R. D., Griffin, M. L., & McHugh, R. K. (2021) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108507 · Cited by 5
Self-citation
Substance use patterns, quantities, and associated risk factors in women with polysubstance misuse
Fogelman, N., Tate, M. S., Wemm, S., Sullivan, L., Hart, R. L. D., Vacey, E., Fox, H. C., & Sinha, R. (2024) · Addiction Biology · doi:10.1111/adb.13390 · Cited by 4
Dampening of Positive Affect Predicts Substance Use During Partial Hospitalization
Peckham, A., McHugh, R. K., Kneeland, E. T., Björgvinsson, Þ., & Beard, C. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10101-8 · Cited by 4
Self-citation
Psychometric properties of the Treatment Effectiveness Assessment in methamphetamine use disorder
Vo, H. T., Kulikova, A., Mayes, T. L., Carmody, T. J., SHOPTAW, S. J., Ling, W. W., Trombello, J. M., & Trivedi, M. H. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.209085 · Cited by 4
The Lock-In Loophole: Using Mixed Methods to Explain Patient Circumvention of a Medicaid Opioid Restriction Program
Roberts, A. W., Skinner, A. C., Lauffenburger, J. C., & Galt, K. A. (2019) · Substance Abuse · doi:10.1080/08897077.2019.1674239 · Cited by 4
Relationship between Drug Craving and HighRisk Situations for Relapse Among Inmates with Substance Abuse Issues
Yunos, N., Ibrahim, F. B., Zakaria, E. B., Sulaiman, W. S. W., Hassan, N., Kamaluddin, M. R., & Tharshini, N. K. (2021) · International Journal of Current Research and Review · doi:10.31782/ijcrr.2021.131819 · Cited by 4
Design and implementation of a cohort study of persons living with HIV infection who are initiating medication treatment for opioid use disorder to evaluate HIV-1 persistence
Schultheis, A., Sanchez, M., Steinhauser, S. F., Kyriakides, T. C., Ho, Y., Kluger, Y., & Springer, S. A. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100866 · Cited by 4
Effects of live-online, group mindfulness training on opioid use and anxiety during buprenorphine treatment: A comparative effectiveness RCT
Rosansky, J. A., Howard, L., Goodman, H., Okst, K., Fatkin, T., Fredericksen, A. K., Sokol, R., Gardiner, P., Parry, G., Cook, B. L., et al. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107417 · Cited by 3
Helping Opioid Use Disorder and PTSD with Exposure (HOPE): An Open-Label Pilot Study of a Trauma-Focused, Integrated Therapy for OUD/PTSD
Saraiya, T. C., Singal, S., Prakash, K., Johal, P. K., Hameed, S., Back, S. E., Mills, K. L., & Hien, D. A. (2025) · Behavioral Sciences · doi:10.3390/bs15070874 · Cited by 3
“Opioid craving was measured by the Desire for Drug Questionnaire (DDQ; Franken et al., 2002) and the Opioid Craving Scale (OCS; McHugh et al., 2014).”
Discontinuation of medication treatment for opioid use disorder after a successful course: The discontinuation phase of the CTN-0100 (RDD) trial
Shulman, M., Provost, S. E., Ohrtman, K., Novo, P., Meyers-Ohki, S. E., Veldhuisen, P. C. V., Oden, N. L., Otterstatter, M. C., Bailey, G. L., Liu, D., et al. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107543 · Cited by 3
Self-citation
Pain severity contributes to worse outcomes in opioid use disorder recovery than pain status
Craft, W. H., Craft, C. L., Tegge, A. N., Athamneh, L. N., Stein, J. S., Keith, D. R., Moigne, A. L., DeVeaugh‐Geiss, A., Chilcoat, H. D., & Bickel, W. K. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2024.112530 · Cited by 3
A pilot study of benzodiazepine cue-induced craving
McHugh, R. K., Korte, F. M., McCarthy, M. D., & Geyer, R. B. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109443 · Cited by 3
Self-citation
Pain in the management of opioid use disorder
SIROHI, S. K., & Tiwari, A. K. (2016) · Journal of Pain Research · doi:10.2147/jpr.s123667 · Cited by 3
“24,25 Craving has been shown to predict lapse to opioid use in patients receiving treatment for OUD, 26,27 and a recent study reported that among patients treated for OUD, those with chronic pain had higher opioid craving.”
Background
STRategies to Improve Pain and Enjoy life (STRIPE): Protocol for a pragmatic randomized trial of pain coping skills training and opioid medication taper guidance for patients on long-term opioid therapy
Wartko, P. D., Boudreau, D. M., Turner, J. A., Cook, A. J., Wellman, R., Fujii, M., Garcia, R., Moser, K. A., & Sullivan, M. D. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106499 · Cited by 3
Moving beyond self-report in characterizing drug addiction: Using drug-biased behavior to prospectively inform treatment adherence in opioid use disorderPreprint
McClain, N. E., Ceceli, A. O., Kronberg, G., Nelly Alia-klein, A., & Goldstein, R. Z. (2025) · medRxiv · doi:10.1101/2025.01.01.25319860 · Cited by 3
Differential Experience of Interdose Withdrawal During Long-Term Opioid Therapy and its Association With Patient and Treatment Characteristics: A Latent Class Analysis in Chronic Pain Population
Rodríguez-Espinosa, S., Coloma‐Carmona, A., Pérez-Carbonell, A., Román-Quiles, J. F., & Carballo, J. L. (2022) · Journal of Pain · doi:10.1016/j.jpain.2022.03.236 · Cited by 2
Preliminary Evidence of the Association between Time on Buprenorphine and Cognitive Performance among Individuals with Opioid Use Disorder Maintained on Buprenorphine: A Pilot Study
Pericot‐Valverde, I., Byrne, K. A., Ortiz, E. G., Davis, S. C., Hammond, E., Nahvi, S., Thrasher, J. F., Sivaraj, L. B., Cumby, S., Goodwin, E., et al. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20166610 · Cited by 2
“BMT participants also completed the Opioid Craving Scale (OCS) [27], a 3-item scale assessing urges, cue-induced-craving, and the likelihood of use on a visual analogue scale from 0 to 10.”
BackgroundInfluential
Evaluation of intervention components to maximize yoga practice among people with chronic pain taking opioid agonist therapy: A factorial experiment using the multiphase optimization strategy framework
Uebelacker, L. A., Braun, T. D., Taylor, L. E., Saper, R. B., Baldwi, M., Abrantes, A. M., Tremont, G. N., Toribio, A., Kirshy, S., Koch, R., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107411 · Cited by 2
Opioid use disorder and role of yoga as an adjunct in management (OUDARYAM): Study protocol for a randomized controlled trial
Bhargav, H., Holla, B., Mahadevan, J., Jasti, N., Philip, M., Sharma, P., Vedamurthachar, A., Mehta, U. M., Varambally, S. S., Venkatasubramanian, G., et al. (2024) · Wellcome Open Research · doi:10.12688/wellcomeopenres.19392.1 · Cited by 2
“3) Opioid craving scale 58 : It is a three-item test that is a reliable and valid tool to assess craving in opioid use disorders 59 and has been used in many studies before.”
Self-citation
Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder
Okafor, C. N., Carmody, T. J., Stotts, A. L., Bart, G. B., Mayes, T. L., Karns-Wright, T., Trivedi, M. H., SHOPTAW, S. J., & Potter, J. S. (2024) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2024.100230 · Cited by 2
“The study used a Visual Analogue Scale (VAS) to assess methamphetamine craving over the past week (McHugh et al., 2014), with the VAS ranging from 0 (no craving) to 100 (most intense craving possible).”
Method
Evaluating a mobile app’s effects on depression and anxiety in medication-treated opioid use disorder
Heinz, M. V., Lekkas, D., Abreu, V., Lee, C. M., Marsch, L. A., & Jacobson, N. C. (2024) · npj Mental Health Research · doi:10.1038/s44184-024-00086-7 · Cited by 2
“The OCS has demonstrated strong predictive validity, with a 17% higher odds of using opioidsforeach1pointincreaseincravings 80 .”
Randomised clinical trial of a 16 mg vs 24 mg maintenance daily dose of buprenorphine to increase retention in treatment among people with an opioid use disorder in Rhode Island: study protocol paper
Armeni, K., Chambers, L. C., Peachey, A. M., Berk, J., Langdon, K. J., Peterson, L., Beaudoin, F. L., & Wightman, R. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085888 · Cited by 2
A Shared Decision-Making Tool to Prevent Substance Abuse: Protocol for a Randomized Controlled Trial
Long, J., Yuan, J. M., & Johnson, R. K. (2018) · JMIR Research Protocols · doi:10.2196/resprot.7650 · Cited by 2
“• Adapted from the 3-item Opioid Craving Scale by McHugh et al [31], participants will be asked to rate on a scale from 1 to 10 how much they currently crave a drug, how strong their desire to use has been when something in the environment reminded them of the drug, and the likelihood that they would use the drug in a…”
Assessment of the Short Grit Scale in patients with substance use disorder: Psychometric properties and patient characteristics
Trinh, C. D., Griffin, M. L., Li, V., McHugh, R. K., & Weiss, R. D. (2023) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2023.2181702 · Cited by 2
“Recovery from substance use disorder requires sustained interest and effort to confront challenges such as external stress (1), withdrawal symptoms (2), and craving (3).”
BackgroundSelf-citation

Authors: McHugh, R. K., Fitzmaurice, G. M., Carroll, K. M., Griffin, M. L., Hill, K. P., Wasan, A. D., & Weiss, R. D.
Affiliations: Harvard University (US)
Yale University (US)
University of Pittsburgh (US)
ORCID: McHugh, R. Kathryn
Fitzmaurice, Garrett M.
Carroll, Kathleen M.
Griffin, Margaret L.
Hill, Kevin P.
Wasan, Ajay D.
Weiss, Roger D.
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2014-12
Volume: 145
Pages: 121-126
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2014.10.002
PMC: PMC4254575
OpenAlex: W1967066293
Cited by: 133
References: 41
Citations by year: 2026: 14 · 2025: 16 · 2024: 12 · 2023: 15 · 2022: 17 · 2021: 16 · 2020: 16 · 2019: 13 · 2018: 3 · 2017: 5 · 2016: 6
FWCI: 3.65
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Drug Abuse (R00DA029115, K24DA022288, K99/R00 DA029115, U10DA015831, K23DA035297)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: craving, prescription opioid dependence, recurrence prediction, cue-induced craving, opioid use, addiction treatment
MeSH terms: Adult, Analgesics, Opioid, Heroin, Female, Humans, Male, Narcotic Antagonists, Opioid-Related Disorders, Drug Prescriptions, Substance Abuse Treatment Centers, Young Adult, Self Report, Craving

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Assessing craving and its relationship to subsequent prescription opioid use among treatment-seeking prescription opioid dependent patients

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