Cannabis cue exposure: a pilot study about extinction contexts

Cue-exposure therapy can reduce cravings elicited by conditioned cues such as drug paraphernalia. However, relapse may still occur due to transient reductions in cravings. Cue-exposure therapy occurs in a therapeutic setting, while drug use occurs outside of this setting. Thus, cravings may return due to a change in context since extinction memories are best retrieved in the extinction context. In addition, increases in distress tolerance that may occur during cue-exposure may renew following a context change. The aim of this pilot study is to investigate renewal of cravings towards cannabis paraphernalia and distress intolerance. Participants (N=15) who smoke cannabis in their lounge room were randomly allocated to one of two conditions. In the AAA condition, participants underwent pre-exposure assessment, cue-exposure sessions, and post-exposure assessment in a lounge room. In the ABA condition, participants underwent the pre- and post-exposure assessment in the lounge room, but cue exposure in a therapist office. Additionally, participants completed the study intensively or daily. Preliminary findings suggest that daily cue exposure in the same context is the most effective in reducing cravings and increasing tolerance. Furthermore, renewal of self-reported cravings may occur due to a context change following cue exposure. This pilot study provides methods for improving future research and treatment for cannabis use didorder.