(PS1-A10) A Thematic Analysis of Personalized Imagery Substance Cue Scripts Among Black Adults

Objective: To thematically analyze the triggers for substance use reported among Black adults who participated in an ecologically validated personalized imagery script-based laboratory experiment.

Methods: Thirty-six Black adults (mean age [years] = 37.47, SD = 7.30; 53% male, 33% with alcohol use disorder, 33% with cocaine use disorder, and 33% healthy controls) participated in a laboratory study involving appetitive cue scripts. Appetitive scripts included an event from the past year that comprised of distinct desire to use substance followed by explicit substance use. The reported substance use event was developed into a paragraph-long personalized imagery script for a later laboratory session. The themes reported across scripts regarding triggers for use were identified using thematic analysis.

Results: The following trigger themes emerged followed by example quotes: Exposure to friends/associates who use substances: “As you get up to leave, she says to stay cos’ some company are coming. You sit back down in the dining room. You know that they’ll be bringing some stuff. Your heart beats faster. You are going to get high.”; Money/Payday: “It’s pay day. Your heart beats faster. You know you can get high today. […]”; Wish to celebrate/ special occasion: “They offer you the job right there on the spot. Your heart beats faster. Now you really want a drink. You want to celebrate”; Availability of substance: “Then the waitress walks over to your table and puts a Heineken at your table. You tighten the muscles of your face. She’s made a mistake. You didn’t order it. You look at the bottle closely […] You tell her you didn’t even order it! […] You notice the condensation dripping from the bottom of the bottle. Your mouth waters. You tell her to leave it there.”; Party environment: “The rule is to have a drink with whoever comes through the door. You can’t wait for the fun night of drinking and partying to begin”; Thoughts of using substance: “You are lying in bed, trying to sleep. You toss this way and then the other. Your heart quickens. You can’t fall asleep. Your mind is racing. All you can think of is getting high […]”; and Socially-expected substance use event: “Everyone else is drinking and talking junk. Your stomach is in a knot. You feel like something is missing.”.

Conclusion: This study identified seven situations that led to substance use among Black adults. These findings can inform potential situations to discuss in treatment when planning for high-risk situations for substance use (e.g., in the coping with craving module of cognitive behavioral therapy for substance use disorder). Attending to high-risk situations for use relevant to Black adults is one approach for potentially improving treatment retention, satisfaction, and outcomes among this group.