Cocaine use is associated with increased craving in outpatient cocaine abusers.

Sixty-one cocaine abuse patients provided self-reports of craving and urine samples 3 times a week. Within-subject analyses revealed several relationships between the measures. First, peak craving levels were higher for 2-3-day intervals during which cocaine use had occurred than for preceding or following abstinent intervals. Second, average craving ratings during cocaine use intervals were double the ratings given during abstinent intervals. Third, cocaine use was 4 times more likely to occur during a period of elevated craving than during comparison intervals. Finally, participants who provided at least 1 positive urine sample reported more craving increases over 4 weeks than did abstinent individuals. These results demonstrate a strong association between craving increases and naturally occurring cocaine use but do not allow a determination of whether craving caused cocaine use or cocaine use caused craving.