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Progress in Cue Exposure Therapy for the Treatment of Addictive Disorders: A Review Update

Objectives: To evaluate the role of cue exposure therapy in addiction treatment. Methods: A Pubmed/PsycInfo literature search was performed for cue exposure treatments for addictions from 2002 to 2009. Findings: We located sixteen cue exposure therapy studies involving multiple addictions that were conducted between 2002 and 2009. Four of these studies consisted of clinical efficacy trials that assessed drug use after Cue Exposure Therapy (CET). In three of the four trials, cue exposure was no better or worse than the comparison therapy. Two trials showed somewhat worse retention in those receiving CET and one appeared to have higher relapse rates in those receiving CET. We did not find evidence of safety concerns in any of the four trials. Several promising methodological innovations included use of virtual reality, medication augmentation, investigation of renewal effects, use of fMRI methods, and study of individual differences. Conclusions: Superior efficacy for CET over other forms of general treatment has not been demonstrated. However, research in this area may yet be advanced through adequately powered, multi-site CET trials combining multiple methodological innovations including investigation of individual differences and medication augmentation. Until such trials are conducted, cue exposure treatment for addiction will remain a speculative and uncommonly used therapy in clinical settings.