Cue-exposure treatment for substance abuse

This is a paper I wrote for my introductory Psychology class.
I would like to note that I was one of three working on this paper. Other contributors: Caitlin Coughler and Drago Putica.

Drugs and alcohol have very similar effects on the body. Therefore, the word ‘substance(s)’ for our purposes will refer to both alcohol and drugs. Addicts of both substances are generally subjects of classical conditioning, in the sense that they experience conditioned tolerance and conditioned withdrawal. Conditioned tolerance is where certain environmental cues trigger conditioned responses (CR) in the body, before a substance is even administered, in order to help the body cope with the administration of that substance. Conditioned withdrawal occurs when a patient is exposed to these environmental cues, elicits the appropriate CR’s, and then is not administered the substances (O’Brien et.al., 1992). Conditioned withdrawal is common in previously treated patients and is the primary cause of many relapses.

            Classical conditioning is the main method used when trying to extinguish conditioned withdrawal. In classical conditioning of substance abuse, the environment or conditions in which the substance is being taken is the CS, the substance itself is the UCS, and the effects of the substance are the UCR (Conklin et.al., 2002). Using the cue-exposure method patients are shown various types of CR-eliciting stimuli in a controlled environment, such as images, movies, audio and other cues (Conklin et.al., 2002). As CR’s are elicited patients feel conditioned withdrawal and in some cases drug users even experience euphoria. The substance, however, is never administered (O’Brien et.al., 1992). Through many trials the elicited CR gradually becomes less severe and the patient feels fewer withdrawal symptoms. This treatment is very successful in controlled environments, however, after treatment when the patient returns to their native environment they often relapse (O’Brien et.al., 1992). There could be many cues that cause conditioned withdrawal, and the controlled environment is just not able to replicate them effectively. Patients who undergo cue-exposure treatment are also more likely to drop the treatment because they cannot handle the withdrawal (Marlies et.al., 2007). Recently, many researchers have been focusing on the in vivo approach. In this approach, patients in a controlled environment are often exposed to the actual substance, paraphernalia associated with the substance, or may even be administered the substance itself (Conklin et.al., 2002). This more accurately simulates the environmental cues actually experienced by the patient when normally taking the substance. In some cases, conditioning may even occur in the patient’s house or other environments that elicit CR’s (O’Brien et.al., 1992). So far this method of treatment has not proven to be very successful; however, new approaches to this method have been created (Marlies et.al., 2007). One approach is to expose patients to these environmental cues and to coach them with behavioural techniques in order to defeat the withdrawal symptoms. This is a fairly new approach and there are not many statistics on the effectiveness, however it is believed that in time it will be more effective because this method allows environmental cues to be replicated more effectively. Instead of following a general predetermined treatment schedule, certain environments can be modified in order to better accommodate the patient (O’Brien et.al., 1992). As time progresses this technique will become more refined, and hopefully one day it will see high success rates in treating patients who have substance addictions.

Works Cited
Conklin, Cynthia A., and Stephen T. Tiffany. “Applying Extinction Research and Theory to Cue-Exposure Addiction Treatments .” Addiction 97.2 (Feb. 2002): 155-167. Department of Psychological Sciences, Purdue University, West Lafayette, USA. 23 Jan. 2008  <http://www.blackwell-synergy.com/doi/abs/10.1046/j.1360-0443.2002.00014.x>.  

Marlies, Marissena A., Frankenc, H. Ingmar, Blankenb, Peter, Van Den Brinkc, Wim, and Hendriksb, M. Vincent. “Cue Exposure Therapy for the Treatment of Opiate Addiction: Results of a Randomized Controlled Clinical Trial.” Psychotherapy and Psychosomatics 76 (2007): 97-105. Web of Science. 23 Jan. 2008.

O’Brien, Charles P., Anna Rose Childress, A. Thomas McLellan, and Ronald Ehrman. “Classical Conditioning in Drug-Dependant Humans.” The Neurobiology of Drug and Alcohol Addiction. 654 (June 1992): 400-415. Annals of the New York Academy of Science. 23 Jan. 2008.
<http://www.blackwell-synergy.com/doi/abs/10.1111/j.1749-6632.1992.tb25984.x>.