Craving and Self-Efficacy in the First Five Weeks of Methadone Maintenance Therapy: A Daily Process Study

Objective: Among individuals initiating methadone maintenance therapy for heroin addiction, low craving and high self-efficacy are thought to predict treatment response; however, in the case of craving, findings have been inconsistent. This study will test two hypotheses: (1) craving and self-efficacy both predict treatment response and (2) withdrawal symptoms and sleep quality predict greater craving and greater self-efficacy, respectively. Method: An exploratory study using electronic diary data and multilevel models examined these hypotheses. A sample of 21 heroin users was recruited during the first 1-2 days of methadone maintenance therapy to take part in a 5-week diary study. Comparisons were made between days before participants reached a 70 mg or greater dose and subsequent days. This is in keeping with research showing that this dosage corresponds to optimal opioid receptor blockade. Results: Analysis of 449 diary records nested within 21 participants showed a marked decline in heroin use on days...