Importance of substance cues in relapse among heroin users: comparison of two methods of investigation.

Ninety-three heroin users in treatment rated the importance to their last relapse to heroin use of the 13 categories and subcategories of reasons for relapse identified by Marlatt and Gordon (1985). These subject ratings were compared with the consensual categorizations of two independent judges who coded subjects' descriptions of the same relapse episodes. The results showed that, when judges categorized subjects' open-ended responses to questions about their last relapse, temptations or urges in the presence of substance cues were accorded no importance as a reason for relapse, and these categorizations were similar in this respect to previously reported findings. In contrast, when subjects themselves directly quantified the importance of the various relapse categories in precipitating their last relapse, substance-related temptations or urges obtained the highest mean rating of all categories.