The Stimulant Selective Severity Assessment: A replication and exploratory extension of the Cocaine Selective Severity Assessment

Abstract

Background: Cocaine and methamphetamine have similar withdrawal symptoms and many individuals concurrently use both substances; however, no measures concurrently assess withdrawal from multiple stimulants. Objectives: This study’s aim was to explore the Stimulant Selective Severity Assessment (SSSA), a modified version of the Cocaine Selective Severity Assessment (CSSA), in a sample of stimulant users to determine if it can assess withdrawal symptoms in users of one or more stimulants. Methods: Baseline data were analyzed from the STimulant Reduction Intervention using Dosed Exercise trial, a multisite randomized clinical trial that evaluated exercise versus health education on drug use outcomes in individuals with stimulant use disorders. Data were analyzed for internal consistency, construct validity, and scale dimensionality. Results: Internal consistency for the full sample was good (α = 0.81; N = 302), with similar alphas in Cocaine (0.81; n = 177) and Cocaine/Other Stimulant (0.82; n = 92) groups, but with much lower alpha for the group without cocaine use (Other Stimulant, i.e., primarily methamphetamine, α = 0.66; n = 32). Support for construct validity was evidenced by significant positive correlations (r = 0.17 to 0.67) with measures of stimulant craving, depressive symptoms, and pain. Four factors were revealed. Conclusions/Importance: The Stimulant Selective Severity Assessment is a new measure that can be used to assess withdrawal symptoms in users of cocaine or cocaine plus methamphetamine, but it should not be administered to users of methamphetamine only.

Trial registration: ClinicalTrials.gov identifier: NCT01141608.

Keywords:

• Stimulant
• cocaine
• methamphetamine
• withdrawal
• measure

Acknowledgments

Authors MHT and TLG designed the parent study and wrote the protocol. Authors JT, RW, and TFN conducted literature searches and provided summaries of previous research studies. Author IB conducted the statistical analysis. Author RW wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript. The authors would like to thank Thomas Carmody, Ph.D. for statistical assistance during final manuscript revisions and Jeremy A. Kee, M.A., for his administrative assistance.

Declaration of interest

Dr. Walker’s research is funded by NIDA, and Alkermes, Inc. donated medication for a NIDA-funded study (NCT03078075) unrelated to the current manuscript. Dr. Greer is a paid consultant for H Lundbeck A/S. Dr. Trivedi has received research support from the Agency for Healthcare Research and Quality, Cyberonics Inc., National Alliance for Research in Schizophrenia and Depression, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases, Johnson & Johnson, and consulting and speaker fees from Abbott Laboratories Inc., Akzo (Organon Pharmaceuticals Inc.), Allergan Sales LLC, Alkermes, AstraZeneca, Axon Advisors, Brintellix, Bristol-Myers Squibb Company, Cephalon Inc., Cerecor, Eli Lilly & Company, Evotec, Fabre Kramer Pharmaceuticals Inc., Forest Pharmaceuticals, Glaxo Smith Kline, Health Research Associates, Johnson & Johnson, Lundbeck, MedAvante Medscape, Medtronic, Merck, Mitsubishi Tanabe Pharma Development America Inc., MSI Methylation Sciences Inc., Nestle Health Science-PamLab Inc., Naurex, Neuronetics, One Carbon Therapeutics Ltd., Otsuka Pharmaceuticals, Pamlab, Parke-Davis Pharmaceuticals Inc., Pfizer Inc., PgxHealth, Phoenix Marketing Solutions, Rexahn Pharmaceuticals, Ridge Diagnostics, Roche Products Ltd., Sepracor, SHIRE Development, Sierra, SK Life and Science, Sunovion, Takeda, Tal Medical/Puretech Venture, Targacept, Transcept, Vantage Point, Vivus, and Wyeth-Ayerst Laboratories. All other authors declare that they have no conflicts of interest.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health [Award Numbers U10DA020024 and UG1DA020024]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.