Exposure Therapy In Addiction Treatment

While not traditionally associated with treating addiction, researchers have found that certain forms of exposure therapy may be helpful for those early on in their recovery journey. Exposure therapy is one of several therapies used in addiction treatment programs, alongside cognitive behavioral therapy (CBT), motivational interviewing, and more.

Exposure therapy may help prepare someone with a drug or alcohol use disorder (AUD) for triggers in their everyday life, and learn how to cope with urges to use or drink when they arise.

What Is Exposure Therapy?

Exposure therapy is a psychological treatment that is traditionally used to help people confront their fears, or other sources of anxiety or psychological distress. According to the American Psychological Association, there are several variations of this.

Variations of exposure therapy include:

• in vivo exposure: This involves having someone directly confront the source of their fear/anxiety in real life.
• virtual reality exposure: This exposes someone to their fear by way of a virtual reality device, using technology that can simulate the real-world experience.
• interoceptive exposure: This involves intentionally stimulating physical sensations associated with a person’s fear (e.g. sped-up heart rate)
• imaginal exposure: This involves having someone conjure up their fear/source of distress in their mind to confront.

Moreover, the type of exposure therapy studied as a treatment for addiction, including alcohol addiction and opiate addiction, is commonly referred to as “cue exposure” therapy.

How Can Exposure Therapy Treat Alcohol Or Drug Addiction?

Exposure therapy is utilized to help people with a variety of mental health disorders and addictive behaviors.

Exposure therapy may be a helpful treatment for:

• phobias
• generalized anxiety disorder
• social anxiety
• obsessive-compulsive disorder
• post-traumatic stress disorder (PTSD)
• panic disorder
• dual diagnosis (i.e. co)

The body of evidence demonstrating the usefulness of exposure therapy for addiction is small. However, there is some evidence that it can be helpful alongside other treatments commonly offered in drug and alcohol rehab programs.

What Types Of Addiction Can Exposure Therapy Help With?

Exposure therapy may be helpful for a variety of addictions, including behavioral addictions and addiction to substances like drugs and alcohol.

Cue exposure therapy (CET) has been studied as a treatment for:

• alcohol addiction
• opiate addiction
• heroin addiction
• cocaine addiction
• nicotine dependence

What Does Exposure Therapy For Addiction Involve?

Exposure therapy for addiction will typically involve exposing someone with a history of substance abuse to a drug-related stimuli without permitting the drug or alcohol use. For instance, exposing someone to the smell or sight of alcohol. Or, exposing someone to related cues, such as objects, places, or sensations associated with drug or alcohol use behaviors.

Examples might include:

• drug paraphernalia (e.g. syringes, baggies)
• bars/breweries
• certain friends someone associates with their substance use
• drinking glasses
• liquor bottle

Doing this can offer a “cue” for which a person can learn to respond to in ways that don’t involve actually having a drug or using drugs. Through this process, a client can learn to alter their habitual response to stimuli, or other triggers, and thereby become better-prepared to manage them in their everyday lives.

What Are The Benefits Of Exposure Therapy For Addiction?

Clinical trials on the use of this treatment show there’s a possibility exposure therapy could offer some benefits for someone with a history of addictive behaviors.

Benefits of exposure therapy for addiction might include:

• improved self-efficacy
• better emotional processing
• overcoming avoidance tendencies
• treating co-occurring mental health and substance use disorders (SUD)

Exposure therapy may also help someone learn how to manage cravings and alter conditioned responses. It may also help prevent relapse and promote supportive coping skills and strategies.

Is Exposure Therapy An Effective Treatment For Drug Addiction?

Cue exposure treatment is not the most commonly used therapy for treating addiction, and there has been less research on its effectiveness for addiction compared to therapies like CBT. Results on its use for treating addiction are mixed. But there are studies that show exposure therapy may offer some benefit alongside other evidence-based addiction treatments.

Challenges And Limitations Of Exposure Therapy For Addiction

Exposure therapy for addiction comes with challenges that make it less commonly used than other treatments. The major concern is that exposing someone in early recovery to drug or alcohol cues could trigger intense cravings leading to relapse, especially if the person lacks strong coping skills. Timing is critical, as exposure therapy isn’t recommended during detox or very early recovery when someone is most vulnerable.

Exposure therapy requires careful implementation by trained professionals. If done improperly, it could reinforce cravings rather than reduce them. The therapy addresses psychological aspects and learned responses but doesn’t treat physical dependence or underlying issues like trauma or mental health disorders. It’s typically used as supplemental treatment alongside CBT, medication-assisted treatment, and counseling rather than standalone treatment.

Where Can You Find Cue Exposure Therapy For Addiction?

This form of psychotherapy may be offered by individual clinicians, such as an outpatient therapist, or through a formal drug abuse treatment program.

For instance:

• inpatient rehab
• residential treatment
• partial hospitalization
• intensive outpatient programs
• outpatient rehab programs

Not all rehab centers offer exposure therapy for alcohol and drug use disorders. If this is what you are looking for, you’ll have to ask a treatment facility or provider directly if this is a form of treatment they offer.

Written by the Addiction Resource Editorial Staff