In a small pilot study, adults with cannabis use disorder showed blunted positive affect under neutral conditions compared to controls, and personalized scripted imagery was able to elicit positive emotional responses, suggesting a potential tool for treating reward dysfunction.
Addiction therapists, CUD treatment researchers, behavioral intervention designers.
People with CUD showed blunted positive affect under neutral conditions
What the researchers found
CUD participants showed blunted positive affect response to neutral scripts relative to reward scripts (P=0.01). Galvanic skin response was also decreased in neutral vs. reward conditions in CUD (P=0.034). Cortisol was positively correlated with positive affect in controls but not CUD participants (P=0.036). Personalized scripted imagery successfully generated positive emotional responses in CUD participants.
Why it matters
Hedonic dysregulation (blunted pleasure from natural rewards) is a core mechanism of addiction but has been understudied in CUD specifically. If scripted imagery can remediate this, it could become a non-pharmacological treatment tool for cannabis addiction.
The numbers in context
N=22 (10 CUD, 12 controls). Condition x Group interaction on positive affect: P=0.01. GSR: P=0.034. Group x PA interaction on cortisol: P=0.036.
How the study worked
Pilot study comparing CUD adults (n=10) and non-CUD controls (n=12) in a single-session personalized scripted imagery procedure. Natural reward and neutral scripts presented in counterbalanced order. Outcomes: positive affect, galvanic skin response, and cortisol at four timepoints.
What this study cannot tell us
Very small sample (n=22). Single session. No follow-up to assess lasting effects. Cannot determine whether blunted affect preceded or resulted from CUD. Pilot design not powered for definitive conclusions.
How to read the evidence
Very small pilot study (n=22). Establishes proof of concept only.
When this study was published
Published in 2023.
The bigger picture
Most addiction treatment focuses on reducing drug craving, but this study targets the flip side: enhancing the ability to feel pleasure from non-drug rewards. If CUD reduces the brain's capacity for natural reward, restoring that capacity could reduce the pull toward cannabis.
Questions still open
- Would repeated scripted imagery sessions improve hedonic functioning over time in CUD?
- Could this approach be combined with standard CUD treatment for better outcomes?
Common questions
Does cannabis addiction affect the ability to feel pleasure?
Can imagery exercises help cannabis addiction?
Read the original research
Restructuring reward: A pilot study to enhance natural reward response in adults with cannabis use disorder.
Drug and alcohol dependence, 249, 110830
Citation
Sherman, Brian J; Brasher, Zoe E; Baker, Nathaniel L; McRae-Clark, Aimee L; Froeliger, Brett E. (2023). Restructuring reward: A pilot study to enhance natural reward response in adults with cannabis use disorder.. Drug and alcohol dependence, 249, 110830. https://doi.org/10.1016/j.drugalcdep.2023.110830
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