Abstract
Craving, which ranges from a sustained desire for drugs persisting for week to an acute desire passing within minutes, has been described as an important clinical precipitant of relapse in cocaine and opioid abusers and may be a useful surrogate outcome for developing new drug abuse pharmacotherapies. Whereas craving for opioids frequently has been conceptualized as the negative reinforcer of protracted withdrawal or “drug hunger,” craving for cocaine has been conceptualized as the positive reinforcer of remembered euphoria. Medications can reduce both sustained cocaine craving and acute craving induced by a single dose of cocaine, and reductions in both types of craving are correlated with reductions in cocaine use. Furthermore, high level of craving during treatment or during cue-induced challenges predict poor treatment response and later relapse to cocaine abuse in those who have attained abstinence.