What can hunger teach us about drug craving? A comparative analysis of the two constructs

Abstract

While few deny the prevalence of craving among drug-dependent individuals, many theorists have suggested that craving has outlived its usefulness as a meaningful psychological construct. The prevailing notion is that craving reflects an underlying biologic need, but the empirical support for this appears weak. To examine this concern, we review a similar psychological construct: hunger. An intuitive view is that hunger reflects the need to eat due to energy depletion. In this paper, we outline conceptual expectations of the constructs of craving and hunger, and review evidence suggesting that neither craving nor hunger (1) is a simple reflection of underlying biologic need, (2) has reliable physiological correlates or controls, (3) is strongly linked to affective state, or (4) reliably predicts consumption (food or drug). Rather than abandon the study of a compelling psychological construct, researchers ought to re-examine their expectations of craving, and re-focus their attempts to understand the role of craving in drug use. A review of the hunger literature also suggests several fruitful lines for investigation of craving.