{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:17:23Z","timestamp":1778858243880,"version":"3.51.4"},"posted":{"date-parts":[[2026,5,13]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":60,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,13]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To examine the longitudinal dynamic interactions of craving and drug use in the course of treatment of stimulant use disorders.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-lagged residual dynamic structural equation modeling (R-DSEM) was used to examine the reciprocal (bidirectional) longitudinal associations between craving and drug use.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Pooled data from 11 randomized controlled trials of pharmacotherapies for methamphetamine and cocaine use disorders in the United States sponsored by the National Institute on Drug Abuse.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>1,936 adults with cocaine or methamphetamine use disorder.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Measurements<\/jats:title>\n                  <jats:p>Craving was measured using Brief Substance Craving Scale (BSCS), drug use was measured using Timeline Followback and urine drug screen (UDS).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Craving and stimulant drug use were dynamically associated over time (within-person association). Daily craving significantly predicted drug use in subsequent days (estimate=0.092, 95% credible interval [CrI]=0.081, 0.103 for self-reported drug use and estimate=0.081, 95% CrI=0.069, 0.095 for UDS-ascertained drug use). In turn, drug use predicted subsequent craving (estimate=0.361, 95% CrI=0.325, 0.398 and estimate=0.060, 95% CrI=0.028, 0.094, respectively). There was substantial between-person heterogeneity in these cross-lagged effects, as reflected in the coefficients of variation ranging from 0.78 to 2.88.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a bidirectional interaction between stimulant drug craving and drug use. The heterogeneity in the interaction of craving with stimulant drug use may partly explain between-person variability in responses to anti-craving medications in treatment of stimulant use disorders.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.09.26352809","type":"posted-content","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:00:19Z","timestamp":1778688019000},"source":"Crossref","is-referenced-by-count":0,"title":["Stimulant Craving and Drug Use Dynamics: A Cross-Lagged Residual Dynamic Structural Equation Modeling Study"],"prefix":"10.64898","author":[{"given":"Ramin","family":"Mojtabai","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Tulane Medical School, New Orleans, LA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoko","family":"Susukida","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trang Quynh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Farokhnia","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"},{"name":"Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Leggio","sequence":"additional","affiliation":[{"name":"Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Bergeria","sequence":"additional","affiliation":[{"name":"Kahlert Institute for Addiction Medicine, University of Maryland School of Medicine, Baltimore MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smita","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Tulane Medical School, New Orleans, LA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly E.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Kahlert Institute for Addiction Medicine, University of Maryland School of Medicine, Baltimore MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masoumeh","family":"Amin-Esmaeili","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026051507450785000_2026.05.09.26352809v1.1","first-page":"663","article-title":"The toxic effects of cocaine and their treatment","volume":"1","year":"1891","journal-title":"The Lancet"},{"key":"2026051507450785000_2026.05.09.26352809v1.2","unstructured":"Clouston T . Diseased Cravings and Paralysed Control: Dipsomania; Morphinomania; Chloralism; Cocainism, Edinburgh Medical Journal 1889: 35: 508."},{"key":"2026051507450785000_2026.05.09.26352809v1.3","first-page":"442","article-title":"A preliminary study of desipramine in the treatment of cocaine abuse in methadone maintenance patients","volume":"48","year":"1987","journal-title":"J Clin Psychiatry"},{"key":"2026051507450785000_2026.05.09.26352809v1.4","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1984.01790200085011"},{"key":"2026051507450785000_2026.05.09.26352809v1.5","doi-asserted-by":"crossref","unstructured":"Ahmadi J. , Sahraian A. , Biuseh M . A randomized clinical trial on the effects of bupropion and buprenorphine on the reduction of methamphetamine craving, Trials 2019: 20: 468.","DOI":"10.1186\/s13063-019-3554-6"},{"key":"2026051507450785000_2026.05.09.26352809v1.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-009-1655-8"},{"key":"2026051507450785000_2026.05.09.26352809v1.7","doi-asserted-by":"crossref","unstructured":"Margolin A. , Kosten T. , Petrakis I. , Avants S. K. , Kosten T . Bupropion reduces cocaine abuse in methadone-maintained patients, Arch Gen Psychiatry 1991: 48: 87.","DOI":"10.1001\/archpsyc.1991.01810250089015"},{"key":"2026051507450785000_2026.05.09.26352809v1.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300979"},{"key":"2026051507450785000_2026.05.09.26352809v1.9","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1038\/npp.2015.83","article-title":"The effects of naltrexone on subjective response to methamphetamine in a clinical sample: A double-blind, placebo-controlled laboratory study","volume":"40","year":"2015","journal-title":"Neuropsychopharmacology"},{"key":"2026051507450785000_2026.05.09.26352809v1.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.08.005"},{"key":"2026051507450785000_2026.05.09.26352809v1.11","doi-asserted-by":"crossref","unstructured":"Huang M. C. , Fang S. C. , Lin C. , Lin T. , Chang H. M. , Yang T. W. et al. Risk factors for relapse among methamphetamine users receiving a joint legal-medical treatment program as a diversion intervention: A one-year follow-up study, J Subst Use Addict Treat 2023: 151: 208955.","DOI":"10.1016\/j.josat.2023.208955"},{"key":"2026051507450785000_2026.05.09.26352809v1.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2020214"},{"key":"2026051507450785000_2026.05.09.26352809v1.13","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.3390\/brainsci12111546","article-title":"Pharmacological Treatments for Cocaine Craving: What Is the Way Forward? A Systematic Review","volume":"12","year":"2022","journal-title":"Brain Sci"},{"key":"2026051507450785000_2026.05.09.26352809v1.14","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.8.1423"},{"key":"2026051507450785000_2026.05.09.26352809v1.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(00)00217-9"},{"key":"2026051507450785000_2026.05.09.26352809v1.16","first-page":"63","article-title":"The Methamphetamine Treatment Project Corporate A. How long does craving predict use of methamphetamine? Assessment of use one to seven weeks after the assessment of craving: Craving and ongoing methamphetamine use","volume":"1","year":"2009","journal-title":"Subst Abuse"},{"key":"2026051507450785000_2026.05.09.26352809v1.17","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.7.1320"},{"key":"2026051507450785000_2026.05.09.26352809v1.18","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/add.16658","article-title":"Predictors of substance use during treatment for addiction: A network analysis of ecological momentary assessment data","volume":"120","year":"2025","journal-title":"Addiction"},{"key":"2026051507450785000_2026.05.09.26352809v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2006.12.004"},{"key":"2026051507450785000_2026.05.09.26352809v1.20","doi-asserted-by":"publisher","DOI":"10.1007\/BF00443414"},{"key":"2026051507450785000_2026.05.09.26352809v1.21","doi-asserted-by":"crossref","first-page":"245","DOI":"10.15288\/jsad.2019.80.245","article-title":"Drug-Induced Craving for Methamphetamine Is Associated With Neural Methamphetamine Cue Reactivity","volume":"80","year":"2019","journal-title":"J Stud Alcohol Drugs"},{"key":"2026051507450785000_2026.05.09.26352809v1.22","doi-asserted-by":"crossref","unstructured":"Brucar L. R. , Drossel G. , Garza-Villarreal E. A. , Zilverstand A . Subtypes of cocaine use disorder and their neurobehavioral profiles, Transl Psychiatry 2025: 16: 21.","DOI":"10.1038\/s41398-025-03739-z"},{"key":"2026051507450785000_2026.05.09.26352809v1.23","doi-asserted-by":"publisher","DOI":"10.1080\/10550490902925920"},{"key":"2026051507450785000_2026.05.09.26352809v1.24","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1038\/npp.2017.275","article-title":"Exacerbated Craving in the Presence of Stress and Drug Cues in Drug-Dependent Patients","volume":"43","year":"2018","journal-title":"Neuropsychopharmacology"},{"key":"2026051507450785000_2026.05.09.26352809v1.25","doi-asserted-by":"crossref","unstructured":"Hamaker E. , Asparouhov T. , Muth\u00e9n B. Dynamic structural equation modeling as a combination of time series modeling, multilevel modeling, and structural equation modeling. In: Hoyle R., editor. The Handbook of Structural Equation Modeling; 2023, p. 576\u2013596.","DOI":"10.1080\/10705511.2023.2263913"},{"key":"2026051507450785000_2026.05.09.26352809v1.26","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1037\/met0000250","article-title":"A primer on two-level dynamic structural equation models for intensive longitudinal data in Mplus","volume":"25","year":"2020","journal-title":"Psychol Methods"},{"key":"2026051507450785000_2026.05.09.26352809v1.27","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1111\/add.16610","article-title":"Trajectories of craving in the course of pharmacotherapy trials for methamphetamine use disorder","volume":"119","year":"2024","journal-title":"Addiction"},{"key":"2026051507450785000_2026.05.09.26352809v1.28","doi-asserted-by":"crossref","unstructured":"Mojtabai R. , Susukida R. , Farokhnia M. , Nguyen T. Q. , Leggio L. , Bergeria C. et al. Cocaine craving and use during pharmacotherapy trials for cocaine use disorder: A multi-trajectory analysis, Drug Alcohol Depend 2025: 275: 112841.","DOI":"10.1016\/j.drugalcdep.2025.112841"},{"key":"2026051507450785000_2026.05.09.26352809v1.29","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV Washington, DC: American Psychiatric Association; 1994."},{"key":"2026051507450785000_2026.05.09.26352809v1.30","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/10705511.2017.1392862","article-title":"Number of subjects and time points needed for multilevel time-series analysis: A simulation study of dynamic structural equation modeling","volume":"25","year":"2018","journal-title":"Structural equation modeling: a multidisciplinary journal"},{"key":"2026051507450785000_2026.05.09.26352809v1.31","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/10705511.2020.1753517","article-title":"Multilevel autoregressive models when the number of time points is small","volume":"28","year":"2021","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"2026051507450785000_2026.05.09.26352809v1.32","doi-asserted-by":"crossref","unstructured":"Susukida R. , Amin-Esmaeili M. , Mayo-Wilson E. , Mojtabai R . Data management in substance use disorder treatment research: Implications from data harmonization of National Institute on Drug Abuse-funded randomized controlled trials, Clin Trials 2020: 1740774520972687.","DOI":"10.1101\/2020.04.28.20081935"},{"key":"2026051507450785000_2026.05.09.26352809v1.33","doi-asserted-by":"publisher","DOI":"10.1300\/J069v20n03_07"},{"key":"2026051507450785000_2026.05.09.26352809v1.34","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-19981001-08"},{"key":"2026051507450785000_2026.05.09.26352809v1.35","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.00988.x"},{"key":"2026051507450785000_2026.05.09.26352809v1.36","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/15504263.2010.537224","article-title":"Open label pilot study of atomoxetine in adults with adhd and substance use disorder","volume":"6","year":"2010","journal-title":"J Dual Diagn"},{"key":"2026051507450785000_2026.05.09.26352809v1.37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.00986.x"},{"key":"2026051507450785000_2026.05.09.26352809v1.38","doi-asserted-by":"publisher","DOI":"10.1037\/a0030992"},{"key":"2026051507450785000_2026.05.09.26352809v1.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2016.02.005"},{"key":"2026051507450785000_2026.05.09.26352809v1.40","unstructured":"Geiser C. Longitudinal structural equation modeling with Mplus: a latent state-trait perspective New York: The Guilford Press; 2021."},{"key":"2026051507450785000_2026.05.09.26352809v1.41","unstructured":"Asparouhov T. , Muthen, B. Bayesian analysis using Mplus: Technical implementation. 2010. https:\/\/statmodel.com\/download\/Bayes3.pdf"},{"key":"2026051507450785000_2026.05.09.26352809v1.42","unstructured":"Asparouhov T. , Muth\u00e9n B . Practical aspects of dynamic structural equation models, Version 4; 2024."},{"key":"2026051507450785000_2026.05.09.26352809v1.43","doi-asserted-by":"crossref","unstructured":"Gelman A. , Hill J . Data analysis using regression and multilevel\/hierarchical models Cambridge; New York: Cambridge University Press; 2007.","DOI":"10.32614\/CRAN.package.arm"},{"key":"2026051507450785000_2026.05.09.26352809v1.44","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1080\/10705511.2017.1406803","article-title":"Dynamic structural equation models","volume":"25","year":"2018","journal-title":"Structural equation modeling: a multidisciplinary journal"},{"key":"2026051507450785000_2026.05.09.26352809v1.45","first-page":"1506","article-title":"Dynamic structural equation models with binary and ordinal outcomes in Mplus","volume":"56","year":"2024","journal-title":"Behav Res Methods"},{"key":"2026051507450785000_2026.05.09.26352809v1.46","doi-asserted-by":"crossref","unstructured":"Jha M. K. , Ghitza U. E. , Carmody T. , Kuruvila S. , Shoptaw S. , Minhajuddin A. , et al. Craving, Impulsivity, and Subsequent Methamphetamine Use With Naltrexone-Bupropion Versus Placebo: Findings From a Randomized Clinical Trial, J Addict Med 2025.","DOI":"10.1097\/ADM.0000000000001538"},{"key":"2026051507450785000_2026.05.09.26352809v1.47","doi-asserted-by":"crossref","unstructured":"Lassi D. L. S. , Malbergier A. , Negrao A. B. , Florio L. , De Aquino J. P. , Castaldelli-Maia J. M . Pharmacological Treatments for Cocaine Craving: What Is the Way Forward? A Systematic Review, Brain Sci 2022: 12.","DOI":"10.3390\/brainsci12111546"},{"key":"2026051507450785000_2026.05.09.26352809v1.48","doi-asserted-by":"crossref","unstructured":"Baillet E. , Auriacombe M. , Romao C. , Garnier H. , Gauld C. , Vacher C. et al. Craving changes in first 14 days of addiction treatment: an outcome predictor of 5 years substance use status?, Transl Psychiatry 2024: 14: 497.","DOI":"10.1038\/s41398-024-03193-3"},{"key":"2026051507450785000_2026.05.09.26352809v1.49","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-022-01228-w"},{"key":"2026051507450785000_2026.05.09.26352809v1.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.04.010"},{"key":"2026051507450785000_2026.05.09.26352809v1.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.03.011"},{"key":"2026051507450785000_2026.05.09.26352809v1.52","unstructured":"Shoptow S. , Newton T. , Rawson R. A. , Ling W. , Kobahigawa J. Phase 2, double-blind, placebo controlled trial of cabergoline for the treatment of cocaine dependence; 2017."},{"key":"2026051507450785000_2026.05.09.26352809v1.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.04.015"},{"key":"2026051507450785000_2026.05.09.26352809v1.54","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.drugalcdep.2007.05.021","article-title":"A double-blind, placebo-controlled trial of reserpine for the treatment of cocaine dependence","volume":"91","year":"2007","journal-title":"Drug Alcohol Depend"},{"key":"2026051507450785000_2026.05.09.26352809v1.55","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.05.028"},{"key":"2026051507450785000_2026.05.09.26352809v1.56","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1111\/j.1360-0443.2011.03771.x","article-title":"Topiramate for the treatment of methamphetamine addiction: a multi-center placebo-controlled trial","volume":"107","year":"2012","journal-title":"Addiction"},{"key":"2026051507450785000_2026.05.09.26352809v1.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.02.011"},{"key":"2026051507450785000_2026.05.09.26352809v1.58","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301481"},{"key":"2026051507450785000_2026.05.09.26352809v1.59","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.drugalcdep.2015.01.036","article-title":"Bupropion for the treatment of methamphetamine dependence in non-daily users: a randomized, double-blind, placebo-controlled trial","volume":"150","year":"2015","journal-title":"Drug Alcohol Depend"},{"key":"2026051507450785000_2026.05.09.26352809v1.60","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.07.007"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.05.09.26352809","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:45:27Z","timestamp":1778856327000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.05.09.26352809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":60,"URL":"https:\/\/doi.org\/10.64898\/2026.05.09.26352809","relation":{},"subject":[],"published":{"date-parts":[[2026,5,13]]},"subtype":"preprint"}}