Not gunna lie, I wasn't overly impressed by that. Before posting why, I'll just state that I only read the introduction and discussion, assuming that data analysis was appropriate. So perhaps I've missed stuff, and feel free to bring me up on anything I have missed. But anyways, I don't see why in your discussion you spend the whole time criticizing your actual study, which was still an improvement on prior. By all means, some consideration of limitations is appropriate, but it seems to dominate the discussion manuscript. Here's some of my thoughts:
Because ecstasy may contain adulterants, and users do not always know what drugs they are consuming when they take “ecstasy,” any craving they might experience could also reflect a desire for a combination of subjective experiences that are not easily interpreted by the drug user. Additionally, some adulterants (e.g., amphetamines) might be more physiologically addictive and craving for the adulterated drug might be stronger than the craving for MDMA alone.
This doesn't make sense to me. I've taken both MDMA & regular amphetamines, the latter are certainly more crave-inducing (at least for me). You're suggesting that you didn't find cravings for MDMA because it is often adulterated with other
more addictive amphetamines? Surely if this was the case you'd have found the opposite effect - increased cravings and desires to take "Ecstasy", because the adulterants are more inherently addictive. Thus, when you provided the ecstasy stimuli you'd also trigger desires to consume regular amphetamines associated with the stimuli.
We also recognize that the specific photos and music used in this study may have elicited only limited reactivity, and other forms of cue exposure (e.g., script instructing participants to imagine preparing to use ecstasy) might have elicited more pronounced craving.
Couldn't this also suggest that ecstasy isn't actually that crave-inducing, considering that you'd need more ecologically valid stimuli to elicit a significant craving response? Not sure about cause & effect on this one. Were the photos and music, like you say, just not strong enough to cause a craving response or, conversely, is the drug associated with the stimuli not crave-inducing enough to cause a reaction to the stimuli? I guess the only way to find out would be to provide more ecologically valid stimuli.
Nonetheless, frequency counts for six of the eight statements revealed that one-third to one-half of the recreational users in our sample agreed with statements indicative of craving.
Isn't this just a report of an ultimately statistically insignificant finding though? The data, as a whole, suggested that it didn't cause craving.
Although the survey software was programmed to remind participants to use their speakers, allow time for the video to load completely in their web-browser, and confirm that they had watched the video, some may have been distracted when watching and listening to the cue exposure stimuli and when responding to the questionnaires
Tenuous speculation...
Similar to Hopper et al. (2006), most of our participants did not report high levels of craving for ecstasy, as evidenced by the negative mean craving score even after drug-related cue exposure. There are several possible reasons for this finding. First, users of ecstasy may not experience intense craving for this drug, especially
when they are not actively planning to consume ecstasy.
Surely this deserved more discussion than, well, just this! Not only is it consistent with the prior research, but it's also the main finding of your study! I mean, what follows is just a list of reasons why this may not be the case, which I discussed in the prior quotes, which are tenuous to me for the reasons I posted. The rest being problems with your inventory, which is all fair enough, but where is the discussion assuming that the results are indeed correct and not skewed by the methodological issues? You have prior empirical evidence (Hopper et al), your own empirical data and strengths of your methodology as a rationale to discuss this, and "users of ecstasy may not experience intense craving for this drug, especially when they are not actively planning to consume ecstasy" is just about the only mention of it. I don't really understand that. Your whole study was trying to determine that, and the implications are barely even mentioned.
Third, the ECQ-CC asked about various components of craving (e.g., urges, strong desire, intention to consume, anticipated loss of control)
I'm not really sure I agree with the way the word "craving" has been generally applied to everything. The reason I bring this up is because craving is usually desired with drug addiction. But in the context you're using it, it seems to just apply to "wanting to do anything". Here's an example (but there are numerous):
Another limitation of the ECQ-CC (or any other multi-item questionnaire of ecstasy craving) is that it may measure craving for certain outcomes, such as increased energy or sensory changes, better than it measures craving for other outcomes, such as social connection or transcendence of reality.
As human beings, we will always have
reasons for why we choose to consume any drug. It seems like these reasons have been converted into "cravings". I mean, if I wanted to play football because I enjoy exercise, competition and socializing with my friends, I wouldn't regard those as "cravings". If I want to go to the pub for "social connection" I wouldn't regard that as a "craving". I guess the main problem is that the word craving has an implication bias toward addictive behaviours, and seems to be used in this context simply because it is a piece of drug research.
Anyway, that's just my honest thoughts. Thanks for keeping us updated, appreciate that!
