A Pilot Study Found People With Cannabis Use Disorder Have Blunted Pleasure Responses That Could Be Targeted by Scripted Imagery

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.

Sherman, Brian J et al.·Drug and alcohol dependence·2023·Preliminary EvidencePilot Study
RTHC-04933Pilot StudyPreliminary Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Pilot Study
Evidence
Preliminary Evidence
Sample
N=10

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?Would repeated scripted imagery sessions improve hedonic functioning over time in CUD?
  • ?Could this approach be combined with standard CUD treatment for better outcomes?

Trust & Context

Key Stat:
People with CUD showed blunted positive affect under neutral conditions
Evidence Grade:
Very small pilot study (n=22). Establishes proof of concept only.
Study Age:
Published in 2023.
Original Title:
Restructuring reward: A pilot study to enhance natural reward response in adults with cannabis use disorder.
Published In:
Drug and alcohol dependence, 249, 110830 (2023)
Database ID:
RTHC-04933

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A small preliminary study to test whether a larger study is feasible.

What do these levels mean? →

Frequently Asked Questions

Does cannabis addiction affect the ability to feel pleasure?

In this pilot study, people with cannabis use disorder showed blunted positive emotional responses under neutral conditions compared to non-users, consistent with hedonic dysregulation.

Can imagery exercises help cannabis addiction?

Personalized scripted imagery successfully generated positive emotional responses in this small study. Whether repeated sessions could improve reward functioning in CUD requires further research.

Read More on RethinkTHC

Cite This Study

RTHC-04933·https://rethinkthc.com/research/RTHC-04933

APA

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

MLA

Sherman, Brian J, et al. "Restructuring reward: A pilot study to enhance natural reward response in adults with cannabis use disorder.." Drug and alcohol dependence, 2023. https://doi.org/10.1016/j.drugalcdep.2023.110830

RethinkTHC

RethinkTHC Research Database. "Restructuring reward: A pilot study to enhance natural rewar..." RTHC-04933. Retrieved from https://rethinkthc.com/research/sherman-2023-restructuring-reward-a-pilot

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.