Substance use disorders (SUDs) are chronic conditions influenced by various societal, psychological, and physiological factors that considerably impact their course, maintenance, and recovery. Drug craving, as a proximal risk factor, can precipitate relapse and perpetuate substance use. Psychological distress (PD) and difficulties in emotion regulation (DER) are significant distal risk factors that may facilitate craving and subsequent relapse. This study aimed to examine the relationship between DER and craving in patients with SUDs and the extent to which psychological distress mediates this relationship. The Difficulty in Emotion Regulation Scale (DERS-16), the Temptations to Use Drugs Scale (TUD), and the Depression, Anxiety, and Stress Scale (DASS-21) were used. According to the findings, the total DASS-21 scores acted as a mediator between DER and craving. This association was also mediated by the DASS-21 stress and depression subscales. However, anxiety had no significant role in mediating this relationship. Since DER increases the likelihood of craving in patients with SUD, our results underline the significance of providing them with constructive emotion regulation skills. Furthermore, findings suggest that patients with SUD crave drugs to decrease DER-related depression and stress; hence, tailoring therapeutic approaches to address their psychological triggers of craving is critical.
