scholarly journals Minding the Gap: Leveraging Mindfulness to Inform Cue Exposure Treatment for Substance Use Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Christine Vinci ◽  
Leslie Sawyer ◽  
Min-Jeong Yang
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Mindfulness Practice ◽  
Future Research ◽  
Cue Exposure ◽  
Exposure Treatment ◽  
Conditioned Responses ◽  
Use Behavior ◽  
Cue Exposure Treatment

Despite extinction-based processes demonstrating efficacy in the animal extinction and human anxiety literatures, extinction for substance use disorders (SUD) has shown poor efficacy (i. e., cue exposure treatment [CET]). Reasons for this lack of success include common threats to extinction, such as renewal and reinstatement. In recent decades, research on mindfulness for SUD has flourished, and a key aspect of these mindfulness-based interventions includes teaching individuals to stay present with whatever experience they have, even if unpleasant, without trying to change/escape/avoid it. Similarly, CET teaches individuals to not escape/avoid conditioned responses (e.g., craving) by engaging in drug use behavior. This paper discusses how mindfulness-based research and practices could positively influence CET through future research (e.g., Could mindfulness practice attenuate renewal? Might mindfulness training + CET enhance the ability to extinguish the most salient or motivational cues?), with the long-term goal of improving SUD treatment.

Pattern of craving response among smokers exposed to virtual reality

2011 ◽  
Vol 26 (S2) ◽  
pp. 91-91
Author(s):  
I. Pericot-Valverde ◽  
O. García-Rodríguez ◽  
K.P. Cabas-Hoyos ◽  
M. Ferrer-García ◽  
J. Gutiérrez-Maldonado
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Virtual Reality ◽  
Secondary Analysis ◽  
Repeated Exposure ◽  
Cue Exposure ◽  
Exposure Treatment ◽  
Long Duration ◽  
Cue Exposure Treatment

IntroductionTobacco craving is an intense desire to smoke. Cue-induced craving is considered the main responsible for relapse after smoking cessation. Cue Exposure Treatment (CET) consists of controlled and repeated exposure to stimuli associated with substance use in order to reduce craving associated.ObjectiveTo analyze the pattern of craving response of smokers exposed to Virtual Reality environments.MethodsForty-six smokers were exposed randomly to complex virtual scenes of 6 minutes long duration with smoking related cues that reproduce typical situations where people use to smokes. Craving was assessed before each exposure and 6 times during navigation with a visual analogic scale. For this secondary analysis the evolution of craving response were explored for the environments that produced the most and the least craving responses.ResultsIn the environment that produced the highest craving level, the pattern of response remains similar after the second assessment during the exposure, that is, after two minutes. For the environment that trigger the lowest levels, the responses gradually increased during the exposure and the highest level appeared in the last craving assessment, after 6 minutes.ConclusionsThis study has several implications. In the first place, virtual reality environments are able to elicit craving. In the second, we found that differents patterns of craving response exist in response to VR environments. Furthermore, the results obtained in the present study may be useful for cessation programs that include CET, in which is it necessary to know the pattern of desire during the exposure.

scholarly journals Virtual Reality as a strategy for improving the treatment of smoking / La Realidad Virtual como estrategia para la mejora de los tratamientos del tabaquismo

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Olaya García-Rodríguez ◽  
Irene Pericot-Valverde ◽  
José Gutiérrez Maldonado ◽  
Marta Ferrer García
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Virtual Reality ◽  
Relapse Prevention ◽  
The Other ◽  
Prevention Strategies ◽  
Cue Exposure ◽  
Exposure Treatment ◽  
Cue Exposure Treatment ◽  
Entornos Virtuales

El tabaquismo es uno de los mayores problemas de salud pública enla actualidad. Los tratamientos multicomponentes, que incorporan tres fases de intervención (preparación, abandono y mantenimiento), son considerados como el tratamiento de elección para el abordaje esta adicción.No obstante, las altas tasas de recaídas tras las intervenciones hacen que sea necesario incorporar estrategias más eficaces dentro de este tipo de programas para prevenir la vuelta al consumo. Para muchos autores, el craving es la causa de la mayoría de las recaídas. Las técnicas de exposición a pistas o señales consisten en la exposición controlada y repetida a estímulos o entornos asociados al uso de la sustancia, con el objetivo de reducir las respuestas de craving en estas situaciones. La Realidad Virtual ha mostrado su eficacia en el abordaje de diferentes trastornos como método de exposición. Es este artículo, se propone el uso de técnicas de exposición a través de entornos virtuales para la mejora del tratamiento del tabaquismo.  Abstract Smoking is currently one of the biggest problems of public health.Multicomponent treatments, which incorporate three intervention stages (preparation, quitting, and maintenance), are considered the treatment of choice for this problem. However, the high rates of relapse after the intervention make it necessary to incorporate more effective relapse prevention strategies within this kind of programs. For many authors, craving is the cause of most cases of resuming consumption. Cue Exposure Treatment, CET, consist of controlled and repeated exposure to stimuli associated with substance use, in order to reduce craving associated with these situations. On the other hand, recent studies have shown that exposure through virtual settings seems to be a more efficient strategy to present cues than exposure using other procedures. In this paper, cue exposure treatment through virtual reality enviroments are proposed inorder to improve smoking cessation treatments.

scholarly journals Evaluation of a Group Cue-Exposure Treatment for Opiate Addicts

2005 ◽  
Vol 8 (2) ◽  
pp. 229-237 ◽  
Author(s):  
Mónica Bernaldo de Quirós Aragón ◽  
Francisco J. Labrador ◽  
Fernando de Arce
Keyword(s):  
Skin Conductance Level ◽  
Control Group ◽  
Cue Exposure ◽  
Exposure Treatment ◽  
Before And After ◽  
Conditioned Responses ◽  
Opiate Addicts ◽  
Cue Exposure Treatment ◽  
Classically Conditioned ◽  
Experimental Group

Twenty-four detoxified opiate addicts were randomized to an experimental group and a control group to evaluate efficacy of a group cue-exposure treatment to reduce or extinguish classically conditioned responses to drug-related stimuli. Assessment included psychophysiological responses (skin temperature, skin conductance level—SCL—, and heart rate) to a videotape and subjective measures (subjective craving, positive and negative affect) before and after the videotape. The experimental group received a group cue-exposure program to drug-related stimuli that comprised twelve treatment sessions administered three times weekly. The treatment program significantly reduced conditioned responses to drug-related stimuli, as measured by SCL and positive affect.

scholarly journals Recovery-informed Theory: Situating the Subjective in the Science of Substance Use Disorder Recovery

2019 ◽  
Vol 1 (3) ◽  
pp. 1-15 ◽  
Author(s):  
Austin M Brown ◽  
Robert D Ashford
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Systems Of Care ◽  
Grand Theory ◽  
Recovery Strategies ◽  
Recovery Capital ◽  
New Ideas

As recovery from substance use disorder becomes more than a mere quantifiable outcome, there exists a need to discuss and propose the underlying theoretical constructs that ultimately describe and identify the science of recovery. In this abstract undertaking, we propose an initial formulation of a grand theory of recovery science, built upon the seminal theories of recovery capital, recovery-oriented systems of care, and socioecological theory. This grand theory - labeled recovery-informed theory (RIT) - states that successful long-term recovery is self-evident and is a fundamentally emancipatory set of processes. This paper will discuss, analyze, and explore this theory as it is situated within the larger substance use, misuse, and disorder contexts. The uses, implications, and benefits of RIT as an organizing point of inquiry for recovery science are also discussed. By promoting the role of subjective recovery experience in the formulation of the study of recovery, it may be possible to summon new ideas, metrics, and strategies that can directly address substance use disorders in society. Adopting a recovery-informed understanding as follows from this grand theory may allow individual recovery and wellness trajectories to be explored, adapted, and modified to exemplify person-centered and individualized recovery strategies.

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

2021 ◽  
Vol 23 (1) ◽  
pp. 39-52
Author(s):  
Michele Schmitter ◽  
Jeroen Vermunt ◽  
Eric Blaauw ◽  
Stefan Bogaerts
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Latent Class ◽  
Mental Health Problems ◽  
Treatment Approach ◽  
Future Research ◽  
Content Type ◽  
Forensic Patients ◽  
Axis I ◽  
Forensic Psychiatric

Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

Psychosocial Therapies for Substance Use Disorders

2019 ◽  
pp. 41-52
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychosocial Interventions ◽  
Alcohol Problems ◽  
Support Programs ◽  
Treatment Programs ◽  
Mutual Support ◽  
Professional Treatment ◽  
Drug Problems

There are many counseling approaches, treatment programs, and psychosocial interventions for individuals with substance use disorders (SUDs). Although some have been shown in clinical trials to be more effective than others, to date there is no single, superior treatment approach appropriate for all clients. While brief treatments have been successful with alcohol problems, longer term treatments are often needed for drug problems. For clients with more severe SUDs, long-term involvement in professional treatment (including medication-assisted therapies), mutual support programs, or both may be needed. This chapter includes a summary of treatment principles and guidelines that can serve as a framework for helping clients with SUDs.

The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality

2017 ◽  
Vol 171 ◽  
pp. e68
Author(s):  
J.R. Gaither ◽  
J. Goulet ◽  
William Becker ◽  
Stephen Crystal ◽  
E. Jennifer Edelman ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Opioid Therapy ◽  
All Cause Mortality

Psychosocial Treatments for Substance Use Disorders

2015 ◽  
Author(s):  
Daniel M. Blonigen ◽  
John W. Finney ◽  
Paula L. Wilbourne ◽  
Rudolf H. Moos
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Behavioral Interventions ◽  
Contingency Management ◽  
Limited Evidence ◽  
Motivational Enhancement ◽  
Differential Effectiveness ◽  
Cognitive Behavioral Interventions ◽  
Use Behavior

The most effective psychosocial modalities for treating substance use disorders are cognitive-behavioral interventions, motivational interviewing and motivational enhancement, contingency management, community reinforcement, behavioral couples and family therapies, and 12-step facilitation approaches. The foci of these interventions include substance use behavior, patients’ life contexts, and their social and personal resources. Limited evidence is available for these interventions’ differential effectiveness. Brief interventions are highly effective in the treatment of alcohol use disorders. However, as stand-alone treatments, they are best suited for individuals with mild to moderate alcohol use problems. Therapists who are interpersonally skilled, empathic, and nonconfrontational, and who develop a strong therapeutic alliance, are more effective at helping patients achieve better outcomes.

Effectiveness and Availability of Treatment for Substance Use Disorders

2018 ◽  
Author(s):  
Dominic Hodgkin ◽  
Hilary S. Connery
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
The United States ◽  
Treatment Programs ◽  
Future Research ◽  
Dissemination And Implementation ◽  
Major Focus ◽  
Medication Treatment

Drug and alcohol use disorders, also called substance use disorders (SUD), are among the major health problems facing many countries, contributing a substantial burden in terms of mortality, morbidity, and economic impact. A considerable body of research is dedicated to reducing the social and individual burden of SUD. One major focus of research has been the effectiveness of treatment for SUD, with studies examining both medication and behavioral treatments using randomized, controlled clinical trials. For opioid use disorder, there is a strong evidence base for medication treatment, particularly using agonist therapies (i.e., methadone and buprenorphine), but mixed evidence regarding the use of psychosocial interventions. For alcohol use disorder, there is evidence of modest effectiveness for two medications (acamprosate and naltrexone) and for various psychosocial treatments, especially for less severe alcohol use disorder syndromes. An important area for future research is how to make treatment more appealing to clients, given that client reluctance is an important contributor to the low utilization of effective treatments. A second major focus of research has been the availability of medication treatments, building on existing theories of how innovations diffuse, and on the field of dissemination and implementation research. In the United States, this research identifies serious gaps in both the availability of SUD treatment programs and the availability of effective treatment within those programs. Key barriers include lack of on-site medical staff at many SUD treatment programs; restrictive policies of private insurers, states, and federal authorities; and widespread skepticism toward medication treatment among counseling staff and some administrators. Emerging research is promising for providing medication treatment in settings other than SUD treatment programs, such as community mental health centers, prisons, emergency departments, and homeless shelters. There is still considerable room to make SUD treatment approaches more effective, more available, and—most importantly—more acceptable to clients.

scholarly journals Adenosine A2AReceptors in Substance Use Disorders: A Focus on Cocaine

Cells ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 1372 ◽  
Author(s):  
Karolina Wydra ◽  
Dawid Gawliński ◽  
Kinga Gawlińska ◽  
Małgorzata Frankowska ◽  
Dasiel O. Borroto-Escuela ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Current Knowledge ◽  
Ex Vivo ◽  
D2 Receptors ◽  
Future Research ◽  
Receptor Complexes ◽  
Abused Drugs ◽  
The Brain

Several psychoactive drugs can evoke substance use disorders (SUD) in humans and animals, and these include psychostimulants, opioids, cannabinoids (CB), nicotine, and alcohol. The etiology, mechanistic processes, and the therapeutic options to deal with SUD are not well understood. The common feature of all abused drugs is that they increase dopamine (DA) neurotransmission within the mesocorticolimbic circuitry of the brain followed by the activation of DA receptors. D2 receptors were proposed as important molecular targets for SUD. The findings showed that D2 receptors formed heteromeric complexes with other GPCRs, which forced the addiction research area in new directions. In this review, we updated the view on the brain D2 receptor complexes with adenosine (A)2A receptors (A2AR) and discussed the role of A2AR in different aspects of addiction phenotypes in laboratory animal procedures that permit the highly complex syndrome of human drug addiction. We presented the current knowledge on the neurochemical in vivo and ex vivo mechanisms related to cocaine use disorder (CUD) and discussed future research directions for A2AR heteromeric complexes in SUD.

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