Cognitive social learning and related perspectives on drug craving

Many modern theories of drug use and dependence assign central prominence to the role of craving in drug use and relapse. However, some continue to debate whether drug craving has any motivational significance in terms of drug-using behaviors. Cognitive social learning theory adds additional perspective by imbedding craving within a network of cognitive processes that, as they inter-relate, influence drug use and relapse. This paper reviews tenets of cognitive social learning theory as they relate to craving, focusing on theoretical models that have attempted to explain how craving fits our understanding of the process of drug relapse. In addition, cognitive social learning theory complements theories that emphasize more biological or information processing aspects of addictive behaviors. Studies of addiction that have assessed elements of social learning theory suggest the following: (1) there exists an inverse relationship between efficacy and craving; (2) there appears to be an association between affect and craving, but the precise nature and strength of this association is unclear; (3) the relationship between outcome expectations and craving is largely unknown; and (4) correspondingly little is known about relationships between coping and craving. More empirical study is needed to address the strengths and limitations of cognitive social learning theory as it relates to our understanding the motivational significance of drug craving.