Attending to Emotional Cues for Drug Abuse: Bridging the Gap Between Clinic and Home Behaviors
Open accessAbstract
Classical conditioning models of addiction provide keys to understanding the vexing discrepancy between substance abuse patients' desire to abstain when they are in therapy sessions and their tendency to relapse. Experiments using these models demonstrate the power of environmental relapse cues and support clinical approaches, including active exposure, aimed at helping patients recognize and withstand them. Internal cues, including emotions and somatic states such as withdrawal, can trigger urges as powerfully as external cues such as people, places, and things associated with prior abuse. The authors describe a cognitive-behavioral therapy approach that focuses on identifying and actively inducing each patient's high-risk emotions, then helping him or her develop and practice healthy responses. Clinical trials support the approach for patients with panic disorder who have trouble discontinuing benzodiazepines, and early trials suggest it may be useful for patients addicted to other drugs as well.
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Shifts in context, whether external or internal cues, may contribute to relapse in both avoidance-related and appetitive disorders.
“Context changes can include both external and internal cues (Bouton, 2002; Mystkowski, Craske, & Echiverri, 2002; Mystkowski, Mineka, Vernon, & Zinbarg, 2003), and have been identified as a potentially important source of relapse across both avoidance-related and appetitive disorders (M. W. Otto, O’Cleirigh, & Pollack, 2007; Thomas, Larsen, & Ayres, 2003).”
From A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults (2020) · cites this paper as M. W. Otto, O’Cleirigh, & Pollack, 2007
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- Authors
- Otto, M., O'Cleirigh, C., & Pollack, M.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Corresponding author
- Otto, Michael
- Venue
- Science & Practice Perspectives
- Publisher
- NIDA/RTI International
- Published
- 2007-04
- Volume
- 3
- Issue
- 2
- Pages
- 48-56
- ISSN
- 1930-4307 (ISSN-L)
- 1930-4315
- PMC
- PMC2851069
- OpenAlex
- W2086809234
- Cited by
- 26
- References
- 48
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science & Practice Perspectives (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- OpenBU (Boston University) (submittedVersion)
- Funders
- National Institutes of Health (5r01da010040-03)
- National Institute on Drug Abuse (R01 DA 10040, R01DA017904, R10DA009692)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- drug addiction, relapse, emotional cues, classical conditioning, cognitive behavioral therapy, withdrawal, addiction treatment, benzodiazepine discontinuation, panic disorder, craving
- MeSH terms
- Behavior Therapy, Cues, Emotions, Humans, Recurrence, Substance Abuse Treatment Centers, Treatment Outcome, Substance-Related Disorders
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