Randomised pilot study of cannabis cue exposure: Reducing cue reactivity while building tolerance

Abstract

Objective

Cue‐exposure therapy should improve emotion regulation (i.e., reduce cravings and develop tolerance for cravings), but its effects may depend on the context in which it is delivered. The aim of this randomised pilot study was to investigate changes in cannabis cue reactivity and ability to tolerate cravings from pre‐ to post‐exposure within two different contexts and indicate if and how a larger randomised controlled trial (RCT) can be conducted.

Methods

Twenty‐two participants who regularly smoked cannabis in lounge settings were randomly allocated to one of two conditions. In the Same‐Context condition, participants underwent the pre‐exposure assessment, cue‐exposure sessions, and post‐exposure assessment in a lounge room. In the Different‐Context, participants underwent the pre‐ and post‐exposure assessments in a lounge room, but underwent cue exposure in a therapist's office. Participants chose whether to complete sessions daily (5 days of participation) or intensively (2 days of participation) to maximise study recruitment and retention.

Results

Eighteen participants completed the study as required. Only Same‐Context participants’ ability to tolerate cravings from pre‐ to post‐exposure statistically significantly improved. Examination of the magnitude of effect sizes and individual data showed that Same‐Context participants were more likely to benefit from cue exposure than Different‐Context participants (moderate to large effect sizes vs. small to moderate effect sizes). Additionally, cue exposure seemed more effective at building tolerance of cravings (large effect), than reducing them (moderate effect), at least when provided within the Same‐Context.

Conclusions

Although underpowered to assess for statistical differences, this study provides information for a future RCT and for clinical practice.

Abstract

Key words:

• craving
• cue reactivity
• distress tolerance
• emotion regulation
• extinction

Conflict of interest: None.

Conflict of interest: None.

Acknowledgements

This study was funded by a Macquarie University Research Development Grant awarded to Dr. Melissa M. Norberg, Jennifer L. Cornish, and Gabrielle Weidemann. We thank Jennifer Lee and Cathy Jing for their assistance with recruitment, Dr. Carol Newall for her advice on appetitive conditioning, and Dr. Josephine Terry for her assistance with setting up the psychophysiological equipment.

Notes

Conflict of interest: None.

Additional information

Funding

Macquarie University Research Development Grant