BackgroundThis study examined the feasibility, safety, and efficacy of addiction‐focused eye movement desensitization and reprocessing (AF‐EMDR) treatment, as an add‐on intervention to treatment as usual (TAU).MethodsAdult outpatients with alcohol use disorder (AUD) (N = 109) who already received or had just started with TAU (Community Reinforcement Approach) were recruited at 6 outpatient addiction care facilities. They were randomly assigned to either TAU + 7 weekly 90‐minute sessions of AF‐EMDR (N = 55) or TAU‐only (N = 54). Assessments were made at baseline, after AF‐EMDR therapy (+ 8 weeks in the TAU‐only group), and at 1‐ and 6‐month follow‐up. The primary outcomes were changes in drinking behavior as reported by the participant and biomarker indices.ResultsData were analyzed as intent‐to‐treat with linear mixed models. Additionally, sensitivity analyses were performed. No group or interaction effects were found for any of the outcome variables. Only limited change over time was seen with regard to indices of personal and societal recovery and in some secondary indices of clinical recovery (craving, desire thinking, and rumination). Reliable Change Index calculations showed that more TAU‐only participants showed clinical improvement with regard to alcohol consumption while a somewhat higher proportion of participants in the TAU + AF‐EMDR group experienced less craving. The acceptability, safety, and feasibility of the treatments received in both groups were comparable.ConclusionsThere was no add‐on effect of AF‐EMDR on TAU with regard to drinking behavior in outpatients with an AUD. Possible explanations are discussed. Future studies should first establish proof of principle regarding the potential of AF‐EMDR therapy to disrupt operant learning and habits relevant in addiction.
BackgroundAddiction constitutes a major public health problem, and despite treatment, relapse rates remain very high. Preliminary findings suggest that Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based treatment for PTSD, may also reduce craving and relapse rates when applied in substance abuse. This study aims to determine the feasibility, efficacy and effectiveness of EMDR when added to treatment as usual (TAU) for addiction in alcohol dependent outpatients, compared to TAU only.Methods/DesignA single blinded study in which 100 adult patients with a primary DSM-IV-TR diagnosis of alcohol dependence or abuse receiving treatment in one of six Dutch outpatient addiction care facility sites, will be enrolled. After baseline assessment participants will be allocated to one of two treatment conditions (allocation ratio of 1:1) using a stratified (per site, per care pathway), blocked randomization procedure. The intervention consists of EMDR (seven weekly 90 minute sessions) + TAU or TAU only. Assessments are scheduled pre-treatment (t0), post-treatment (t0 + eight weeks), and one and six months post treatment. The effects of both treatment arms are compared on indices of (a) drinking behavior, (b) mediators, moderators and predictors of treatment outcome, (c) quality of life and d) safety, acceptability and feasibility of treatment.Repeated measures ANOVA’s will be conducted using an intention-to-treat and per-protocol approach. Multiple imputation will be used to deal with missing values when possible.DiscussionThis study adapts and extends the standard EMDR treatment for traumatized patients for use with patients with alcohol use disorders without psychological trauma.Trial registrationClinicalTrial.gov: NCT01828866
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