Behavioral and linguistic markers of craving

Craving, a strong desire or urge to use a substance, is a primary trigger for relapse in individuals living with substance use disorder (SUDs). Environmental cues repeatedly paired with substance use can acquire motivational salience, and later exposure to these cues outside of the substance-use context can elicit craving and seeking behaviors. Cue-elicited craving can escalate throughout abstinence and maintain for prolonged periods, a phenomenon known as the incubation of craving. While the striatum has been implicated in forming cue-reward associations, striatal-based reward-learning theories suggest such associations should weaken without reinforcement. In contrast, hippocampal-dependent episodic memories are known to strengthen over time through replay and consolidation, offering a potential mechanism for sustaining substance-related memories and craving. However, the role of episodic memory in craving has been largely underexplored. Here, we investigate that role across food and alcohol craving. First, we show that craving for a food item predicts individuals’ willingness to perform instrumental behaviors for the opportunity to recall a memory about it. Then, using natural language processing techniques, we demonstrate a positive relationship between craving, abstinence length, and the number of episodic details in both food-related and sobriety-related narratives. These findings highlight the potential contribution of episodic memory to sustained craving over time.