- Craving/addiction neuroadaptive theories 
- Cycle of addiction 
- Reward and Anti-Reward pathways 
- Craving Assessment Tools

Neurobiology of Craving in Opioid Use Disorder 

- Slow overall changing of craving level that occurs in the absence of external cues
- May reflect negative effects associated with abstinence or
drug withdrawal and activate the anti-reward system 

Background (Tonic) Craving

- Episodes of fast-onset, short duration spikes of craving 
- Induced by specific drug cues or stressful life events 
- Craving intensity correlates with stress severity

Cue-Induced (Phasic) Craving

- Overwhelmingly strong desire or need to use a drug because of the memory of a pleasant rewarding effect in place of a negative emotional state 
- Strongly associated with patients having opioid misuse 
- Important treatment target to reduce the risk of relapse and
improve patients’ quality of life
- Essential component of dependence syndromes 

Rutgers University

- Substance use disorder
- Chronic and complex neurobiological disease 
- Associated with frequent relapse of taking drugs
- Major public health issue 
- Craving is a main component of OUD and other substance use
disorders

Opioid Use Disorder (OUD)

Kakko J, Alho H, Baldacchino A, Molina R, Nava FA and Shaya G
 2019) Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice.Front. Psychiatry 10:592. doi: 10.3389/fpsyt.2019.00592

Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice

Craving

- Methadone and Buprenorphine are medication treatments used for OUD
- Other treatment options include intravenous diamorphine, oral L-methadone, and slow-release oral morphine but have limited availability in most countries

OUD Pharmacological Treatment 

Patients may benefit from cognitive-behavioral therapy (CBT), motivational interventions, "mindfulness" and contingency management .

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