Extinction of Craving During Exposure to Drug-related Cues: Three Single Case Reports

Abstract

Two opiate abusers and a solvent abuser were exposed to drug-related cues. Self-rated craving showed habituation within all sessions, although there was considerable variability between subjects in the time-course. Habituation between sessions also occurred, although this was less consistent. The level of craving was reduced in one case by a distraction procedure. Cognitive factors were investigated. For one subject anticipation of the stimulus led to high craving while for all three subjects drug-related imagery was associated with high levels of craving. Dysphoric mood states led to a re-emergence of craving (dishabituation) in two cases. One subject showed objective signs, and reported symptoms of opiate withdrawal during the exposure sessions. He had also shown needle-freak behaviour where the syringe and needle produced drugagonistic effects (pleasant, comfortable feelings or excitement). Implications of these results for the treatment of addiction are discussed.