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Craving is a key element of the cannabis withdrawal syndrome that has been associated with continued use and relapse. Although cue-induced cannabis craving has been established in single laboratory sessions, procedures to sustain craving over multiple sessions are needed. The purpose of the present study was to determine if cue-induced craving responses could be elicited in the same subjects across multiple sessions. It was hypothesized that exposure to cannabis cues would produce more robust craving responses than exposure to neutral cues and that elicited craving responses will be sustained across multiple cue exposures. Five experimental cue exposure sessions (1 neutral and 4 cannabis) were conducted. Craving was assessed with the Marijuana Craving Questionnaire (MCQ) Short Form, Visual Analog Scale (VAS), Subject-Rated Physiological Questionnaire, blood pressure, and heart rate. Results revealed significant effects of initial cannabis cue exposure on VAS craving responses and Subject-Rated Physiological measures relative to the neutral cue exposure condition. No significant differences were found on MCQ composite scores or physiological measures. Craving responses following initial cannabis cue exposure were not maintained across sessions. There is a need for a better understanding of the factors that contribute to continued drug use despite quit attempts.

No / Recent research addressing the use of music to support the needs of people receiving treatment for drug addiction has led to the development and implementation of music-assisted therapeutic interventions. We hypothesized that two different music modalities combined with systematic desensitization can counter-condition drug-related cues and significantly reduce the associated craving responses. We further examined the effect of the two treatments on cognitive and psychopathological components of addiction. Twenty-four individuals experiencing drug addiction were randomly assigned to one of the three study groups, namely systematic desensitization (SD) combined with listening to New Age meditation music improvised live on Tibetan bowls (IMT), systematic desensitization combined with listening to relaxing New Age music recorded in individual MP3 devices (NIMT), or a control group that received no additional therapeutic intervention (CTR). Participants in the two treatment groups received six sessions in addition to their standard treatment during a period of three weeks. Evaluation took place at baseline, post-treatment and one month after the end of treatment. Results showed that IMT and NIMT combined with SD significantly reduced craving in response to external drug-conditioned cues, while IMT appeared to be slightly more effective than NIMT in altering permissive thoughts on drug and alcohol use, depression symptoms and everyday life craving reactivity. Further investigation as to the role of music-assisted systematic desensitization as a therapeutic intervention for drug addiction treatment is warranted. / Grant from Grundtvig Education and Culture Lifelong Learning Program (agreement contract number 2013-1-FR1-GRU11-50690).

<p>Substance use disorders are one of the most common psychiatric diagnoses among adolescents; marijuana is the illicit drug used most frequently by youth. Treatment dropout and relapse following treatment are common; innovative strategies are needed to improve treatment outcomes for youth substance abusers. The aim of this study was to develop and evaluate the feasibility of a virtual reality (VR) cue reactivity paradigm for adolescent cannabis abusers and to compare it to a video cue reactivity paradigm. Forty-two treatment-seeking youth with a cannabis use disorder completed the study, which incorporated three parts. During Part 1, drug and neutral video clips were shown to 11 youth and five substance-abuse experts who provided craving/usefulness ratings for each video clip. During Part 2, five youth met in a focus group and then individually to provide input on the development of the VR paradigm. During Part 3, 26 youth completed a laboratory procedure involving neutral and drug-related video clips and VR presentations. Heart rate, skin conductance, and skin temperature were measured as well as craving. Higher levels of craving and skin conductance were observed during drug-related presentations. The presentations did not significantly differ in their ability to elicit craving and arousal. Results suggest that youth can experience subjective and physiological reactivity to VR drug cues warranting further study with a larger, more diverse sample. Implications are discussed.</p> / Dissertation

Nous avons réalisé deux expériences afin d'évaluer l'efficacité de la désensibilisation systématique combinée à la musique et déterminer la contribution exacte de la musique. Dans la première expérience, nous avons comparé l'effet de la désensibilisation systématique combinée à la musique méditative in vivo et l’effet de la désensibilisation systématique combinée à une musique relaxante enregistrée. La comparaison porte sur les niveaux d’envie pendant l'exposition à des stimuli associées à la substance, sur la réactivité à l’envie dans la vie quotidienne, sur les pensées permissives et les croyances liées à l’envie ainsi que sur la dépression et l'anxiété. La deuxième expérience a consisté à identifier la contribution exacte de la musique au contre-conditionnement de stimuli associés à la substance ainsi qu’à l'amélioration des autres variables. Les résultats de la première expérience ont révélé que les deux formes de traitement provoquent une diminution de la réactivité aux stimuli associées à la substance et ont des influences positives importantes sur les autres variables. La deuxième expérience a démontré que l'écoute de la musique relaxante induit des réductions significatives de l’envie pendant l'exposition à des stimuli associées à la substance et qu’elle améliore les croyances liées au comportement compulsif. En conclusion, ces études ont démontré la contribution significative de la musique à la désensibilisation systématique pour le traitement de la dépendance aux substances. Elle ouvre ainsi de nouvelles voies pour l'utilisation de la musique comme un outil thérapeutique complémentaire pour la réhabilitation des personnes dépendantes aux substances. / Two experiments were conducted in order to examine the effectiveness of music-assisted systematic desensitization and determine the exact contribution of listening to music in the therapeutic process. The first experiment examined the effect of live-played meditation music and recorded relaxing music combined with systematic desensitization, on craving responses during exposure to substance-conditioned cues, craving reactivity in everyday life, permissive thoughts on substance use, craving beliefs, depression and anxiety. The second experiment investigated the exact therapeutic contribution of listening to recorded relaxing music in the counterconditioning of cues related to substance use and the extinction of the implicated craving responses, as well as in the amelioration of everyday life craving reactivity, craving beliefs, depression and anxiety. The results of the first trial revealed an emphatic amelioration of craving intensity in response to cues conditioned with substance use and significant or close to statistical significance positive influences on the other variables by both forms of treatment. The findings of the second experiment suggested that listening to recorded relaxing music accounts for significant reductions in craving intensity during exposure to substance-conditioned cues and in craving beliefs associated with compulsive behaviour. In conclusion, this study showed the significant therapeutic contribution of music to in vitro cue-exposure therapy for substance addiction treatment and opens new avenues for future exploration and use of music as a complementary therapeutic tool in the rehabilitation of substance addicted individuals.