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← Back to blogEMDR Addresses Two Distinct Targets in Addiction
Of 150 patients admitted to an addiction unit, 94% had a history of at least one traumatic event. Trauma is not the exception here.
EMDR is used in two different ways in addiction treatment. The first is trauma-focused EMDR: the traumatic memory itself is processed using the standard eight-phase protocol. The second is addiction-focused EMDR: the targets are triggers, craving, and the network of substance-related memories. DeTUR, CravEx, FSAP, and PEIA are protocols in this second group.
The mechanism relies on working memory. In a meta-analysis pooling 53 laboratory studies, performing a second task, such as eye movements,
while recalling a memory reduced both its vividness and its emotional intensity. The same effect was demonstrated for smoking-related imagery, but under laboratory conditions it had disappeared after one week.
The evidence must be interpreted honestly. In a meta-analysis of 14 studies, EMDR showed a moderate effect on craving (g = 0.55), but no significant difference
in addiction severity was found (g = 0.14). In the largest randomized trial in alcohol use disorder, involving 109 patients, addiction-focused EMDR provided no additional benefit over treatment as usual. By contrast, the picture changes with comorbid PTSD: in a randomized trial involving 209 patients, EMDR added to addiction treatment significantly reduced PTSD severity without worsening substance use.
Clinical summary: screen for trauma at the start of treatment, use trauma-focused EMDR if comorbid PTSD is present, consider craving modules as an adjunct,
and continue standard addiction treatment.