The effect of Cue-induced Retrieval and Reconsolidation with Episodic Foresight on craving in opioid users receiving MMT

Background: Targeting maladaptive learning and drug-related memories is one of the major challenges concerning individuals undergoing
addiction treatment. Exposure to drug cues activates drug-related memories that trigger cravings, hindering long-term absinence. This study
explores the efficacy of Cue-Exposure combined with Episodic Future Thinking (CIREF) intervention, a novel approach integrating cue
exposure and envisioning future events to reduce craving (tonic and phasic) in MMT patients. Method: Participants (randomly assigned to
CIREF=14, control=14, Mage=35.97) were asked to generate personalized opioid-related cues for 6 time intervals in the future. The CIREF
protocol consisted of 4 one-hour sessions. Craving assessments were carried out from all the participants at baseline and after 3-week
interventions using Desire for Drug Questionnaire (DDQ) and Obsessive-Compulsive Drug Use Scale (OCDUS). Result: Repeated measure
ANOVA was used to compare the total score and subscales of (DDQ) for 3 time points (phasic craving) and (OCDUS) for 2 time points,
baseline and post-test (tonic craving). The results demonstrated a significant decrease in DDQ total score in the CIREF group compared to
control (F (1.13) = 4.67, P< 0.005). Also, the “Desire and Mental Preoccupation with Drugs” sub-scale scores of OCDUS were significantly
lower in CIREF group (F (1.12) = 14.55, P< 0.005). Conclusion: CIREF demonstrated a profound impact on craving, emphasizing its
potential as a supplementary cognitive intervention for MMT patients. This novel intervention holds promise in mitigating cue-induced
cravings and enhancing control, offering a feasible and effective addition to outpatient clinics' treatment strategies.