An investigation comparing primary and secondary substance cravings between mental health and substance use disorder program inpatients


An investigation comparing primary and secondary substance cravings between mental health and substance use disorder program inpatients


Susan M. Snyder1, James Holland2, Siobhan A. Morse3, Jessica Ingram4

1School of Social Work, Georgia State University, 55 Park Place, Rm. 575, Atlanta, GA 30303, United States of America; 2Horizon Health Mental Health Outcomes, 1965 Lakepointe Dr Lewisville TX 75057; 3Universal Health Services, Inc., 1000 Health Park Drive Building 3, Suite 400, Brentwood, TN 37027, United States of America; 4Horizon Health Mental Health Outcomes, 1965 Lakepointe Dr Suite 100, Lewisville, TX  75057


Background: Mental illness symptoms can trigger substance use cravings, which are strongly associated with relapse.

Aim: Our study examines differences in substances craved among adults entering inpatient mental health (MH) and substance use disorder (SUD) treatment programs in 2018.

Method: Our sample includes 2,486 adults; 1,686 adults admitted to MH programs and 800 adults admitted to SUD programs.  We conducted chi-square tests and Fisher’s exact tests to determine group differences, with a Bonferroni correction to adjust the alpha for multiple tests.

Results: We found that patients programmed to SUD services more often reported alcohol (39.99 vs. 49.63%; x2 (1, N = 2,488) =20.56, p<0.001) and opioid (8. 00% vs. 35.88%; x2 (1, N = 2,488) =299.48, p < 0.001) cravings. Patients programmed to MH primary more often reported cannabis (16. 35% vs. 1.00%; x2 (1, N=2,488) =299.48, p<0.001), stimulants (10.25% vs. 6.13%;  x2(1, N =2,488) = 11.36, p < 0.001), and “other substances” cravings (21.45% vs. 3.25; x2 (2, N = 2,488) =136.52, p <0.001). Both groups mostly did not report secondary cravings.

Conclusions: Because cravings can negatively impact treatment success of patients with co-occurring disorders, cravings should be assessed upon admission to mental health or SUD inpatient treatment.


Keywords: psychiatric treatment, cravings, mental health, substance use, co-occurring disorders

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How to cite this article:

Susan M. Snyder, James Holland, Siobhan A. Morse, Jessica Ingram.An investigation comparing primary and secondary substance cravings between mental health and substance use disorder program inpatients. International Journal of Addiction Research and Therapy, 2022, 5:27. DOI: 10.28933/ijart-2021-11-1205


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