Evaluating The Relative Effectiveness Of Three Aversion Therapies Designed To Reduce Craving Among Cocaine Abusers
Evaluating The Relative Effectiveness Of Three Aversion Therapies Designed To Reduce Craving Among Cocaine Abusers
This article investigates the use of three aversion therapies that are designed to eliminate cocaine craving. The three therapies include faradic, chemical, and covert sensitization. Chemical aversion therapy entails pairing the chemically induced nausea using the emetic agents with smell, sight, thought, and taste of the desired substance. Faradic aversion uses electric shock instead of chemical aversion. Crack cocaine dependence and use have increased, and its treatment approaches vary from the simple psychotherapy to the intensive medication regimes. Craving is a response conditioned with past drug using events, and it is elicited by environmental cues. When performing this study 70 subjects were assigned randomly to one of the 3 aversion treatments. From this study, the results indicated that aversion therapy is useful in reducing crack cocaine craving. Being exposed to cocaine related cues is believed to be a contributing factor for the relapse of 35 % of the sample of 35 users of crack cocaine (Bordnick, P et al 2004). Aversion therapy involves repeated pairing of the drug that is being abused and associated with the paraphernalia with the aversive stimulus like unpleasant images and shock. Through pairing of the aversive stimulus with cocaine use, the addict is supposed to develop an aversion to the smell, sight, taste, and other cues that are associated with the drug use.
This study was intended to examine the effects of the 3 aversion therapies that were designed to eliminate or reduce the craving for cocaine. During the therapy, commercially available aroma of cocaine was used in the emetic and faradic therapies. It was made of methyl cimnamare, methyl benzoate, and dimethyl ester of truxillic acid. The drops of the liquids were placed on the patient’s hand’s so that to provide an olfactory stimulus thus creating the smell of cocaine in the treatment setting. Placedo powdered cocaine was inhaled by patients in both emetic and faradic groups. In the study, the dependent variable was the craving for cocaine. The craving for each patient was rated on 0 -10 scales where, zero represented no craving and 10 represented intense craving that would lead to cocaine use. Patients were asked to rate their cravings after and before every session. The craving rates for the patients were recorded for the 8 session, which totaled to 16 ratings.
The purpose of the study being to determine the effect of the 3 aversion therapies in the ability to eliminate or reduce cocaine craving, the results were as follows. The emetine aversion therapy reduced craving during the treatment session as there was a decrease in craving for crack cocaine (Bordnick, P et al 2004). The outcome of the study indicated that faradic aversion therapy slightly increased craving after every session. This indicates that electrical stimulation does not provide a strong unconditioned stimulus during treatment. The outcome of covert sensitization indicated that craving slightly decreased as a result of the treatment. It also indicated that covert reduces the craving in a large percentage for the patient over the course of treatment. However, it can take long for the reductions to be achieved.
Aversion treatment helps in reducing craving for cocaine. Pairing of placedo cocaine with an aversive stimulus reduces the craving for cocaine. Then data indicated that patients in then aversion therapy become conditioned to be repulsed at smell, sight, taste, and thought of cocaine. Faradic and covert aversion therapies are helpful in reducing cocaine craving over the treatment course. These two therapies can be helpful for those patients who are not able to participate in emetic therapy because of medical complications (Bordnick, P et al 2004). Covert sensitization can be preferred over faradic because of the social validity of the patient not being exposed to electric shock. From the results of the study, emetine aversion appeared to provide the most efficacious method that help in eliminating craving. The decrease from the emetic aversion analysis proves the method to be extremely helpful for patients. This is helpful for those patients who at the start of treatment have an intense craving for cocaine and tend to drop out before other methods are implemented.
According to the study’s outcome it is recommended that the investigators should perform follow up measures. This will enable them to determine how cocaine craving changes when the patient is exposed to environments with cocaine related cues, while in non treatment settings. It is therefore, recommended for people to use aversion therapy in trying to eliminate the craving for cocaine. Aversion therapy has provided an initial evidence of its efficacy in reducing the subjective craving in cocaine abusers (Bordnick, P et al 2004). There is the need to complete replications so that to increase the empirical generalizability and validity of the findings. There has been the lack of efficacious treatment for cocaine abusers in that some can only provide limited periods of abstinence. In spite of emetic therapy having greater effects than that of faradic shock, there is the need for replication so as to further the findings of this study.
Reference
Howard, M (2001). Pharmacological aversion treatment of alcohol dependence The American journal of drug and alcohol abuse 27 (3)
Orr, T Thyer, B & Bordnick, P (2004). Evaluating the relative effectiveness of three aversion therapies designed to reduce craving among cocaine abusers Behavior interventions 19
Steven, T (1985). Effects size estimates in chemical aversion treatment of alcoholism Journal of clinical psychology
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