Eye Movement Desensitization and Reprocessing (EMDR) therapy can help address psychological difficulties associated with drug addiction, particularly when traumatic experiences, emotional distress, or substance-related cravings are involved.
Researchers have examined whether EMDR can reduce cravings, change responses to drug-related memories, and improve emotional symptoms among people with substance use disorders.
EMDR is commonly used to treat post-traumatic stress disorder (PTSD), but its applications also include anxiety, depression, grief, and addiction-related concerns.
In addiction treatment, it may focus on distressing experiences or memories connected with substance use.
Research has reported improvements in cravings and trauma-related symptoms following EMDR. However, findings about overall substance use and long-term recovery are less consistent.
Understanding these differences helps explain where EMDR may fit within a broader addiction treatment approach.
What Is Drug Addiction?
Drug addiction involves repeated substance use that becomes difficult to control despite negative consequences.
Healthcare professionals often use the term substance use disorder to describe problematic patterns of drug use that interfere with health, responsibilities, or relationships.
Substance use disorders can involve opioids, cocaine, methamphetamine, cannabis, prescription medications, and other substances.
People may experience different combinations of symptoms, including:
Strong cravings or urges to use drugs
Difficulty reducing or controlling substance use
Continuing to use despite unwanted consequences
Spending considerable time obtaining or using substances
Changes in daily responsibilities and relationships
Withdrawal symptoms when reducing certain substances
Addiction involves interacting biological, psychological, and environmental factors.
Treatment therefore often combines approaches addressing physical dependence, behavior, emotional well-being, and social circumstances.
How Does EMDR Work in Addiction Treatment?
EMDR is a structured psychotherapy that helps people process distressing memories and associated emotional responses.
During EMDR, a person focuses on aspects of a selected memory while engaging in bilateral stimulation, commonly guided eye movements, alternating sounds, or taps.
The treatment is intended to help memories become less distressing and support more adaptive beliefs.
Unlike some traditional talk therapies, EMDR does not necessarily require extensive verbal discussion of past experiences.
In addiction treatment, EMDR may address traumatic memories, emotionally significant experiences, or memories associated with substance use.
For example, someone may associate drug use with a particular period of emotional distress.
EMDR may help reduce the distress connected with those memories.
Researchers have also examined approaches that focus directly on substance-related cravings rather than traumatic memories alone.
These applications help explain why EMDR is used in both trauma-focused and addiction-focused treatment.
What Is the Connection Between Trauma and Drug Addiction?
Trauma and substance use disorders sometimes occur together.
Some people use drugs to manage difficult emotions, unwanted memories, or distress associated with past experiences.
However, not everyone experiencing addiction has a trauma history, and traumatic experiences do not necessarily lead to substance use disorders.
Researchers have investigated how trauma-related symptoms may influence substance use patterns.
For example, someone experiencing PTSD may notice that anxiety or reminders of past events increase their desire to use a substance.
When both PTSD and addiction-related difficulties are present, treatment may address the two conditions together.
EMDR is particularly relevant because it has substantial research support for PTSD.
Reducing trauma-related distress may contribute to broader emotional improvements, although this does not automatically establish a reduction in drug use.
What Is Addiction-Focused EMDR?
Addiction-focused EMDR adapts elements of standard EMDR to address memories, thoughts, and responses associated with substance use.
Rather than focusing exclusively on traumatic events, treatment may examine experiences connected with craving or the perceived rewarding effects of a substance.
Examples of potential treatment targets include:
Memories associated with previous drug use
Situations that trigger strong cravings
Distressing experiences connected with substance use
Beliefs about needing drugs to manage emotions
Anticipated situations involving substance-related triggers
Researchers have investigated whether processing these experiences can change their emotional intensity or influence craving responses.
However, addiction-focused EMDR protocols are not all identical.
Different studies use different procedures, treatment durations, and outcome measures.
This variation is important when comparing research findings.
Can EMDR Help Reduce Drug Cravings?
Cravings are among the most frequently studied addiction-related outcomes in EMDR research.
A craving is a strong desire or urge to use a substance.
Cravings may be associated with memories, emotions, environmental reminders, or expectations about a drug's effects.
A 2024 meta-analysis published by Martínez-Fernández and colleagues in Brain Sciences examined EMDR and craving reduction among people with substance use disorders.
A meta-analysis combines results from multiple studies to estimate overall treatment effects.
The researchers included five studies involving 266 participants.
The combined findings showed a statistically significant reduction in cravings among participants receiving EMDR interventions.
However, the included studies differed in treatment methods and participant characteristics.
The findings support the potential usefulness of EMDR for craving-related difficulties, but they do not establish that cravings disappear or that reduced craving always produces sustained abstinence.
What Did a 2023 Clinical Study Find?
A pilot randomized controlled trial published in 2023 examined addiction-focused EMDR among adults receiving treatment for substance use disorders.
The study included 30 participants attending a residential or partial hospitalization treatment program in Florida.
Participants were assigned to one of two groups.
The first group received addiction-focused EMDR alongside Cognitive Behavioral Therapy (CBT).
The second group received CBT alone.
CBT helps individuals identify connections between thoughts, emotions, and behaviors while developing alternative coping strategies.
Researchers assessed cravings, repeated substance-related thoughts, and beliefs associated with addiction.
Both treatment groups experienced significant improvements during the intervention.
However, the researchers found no statistically significant differences between the groups.
This means the study did not demonstrate that adding EMDR produced better outcomes than CBT alone.
Because the trial involved only 30 participants, larger studies are needed to clarify the findings.
What Did the 2025 Meta-Analysis Find?
A broader meta-analysis published by Seok and colleagues in 2025 examined EMDR for substance use disorders.
The review included 14 studies and evaluated both addiction-related and emotional symptoms.
Researchers examined craving, addiction severity, PTSD, depression, and anxiety.
The combined results showed statistically significant improvements in several areas.
The reported effect sizes were:
Craving reduction: 0.55
PTSD symptom reduction: 0.69
Depression symptom reduction: 0.64
Anxiety symptom reduction: 0.72
These standardized effect sizes describe the magnitude of changes observed across the included studies.
However, the effect on overall addiction severity was not statistically significant.
This distinction is important.
The findings suggest that EMDR can help with cravings and emotional symptoms without establishing that it consistently reduces the overall severity of substance use disorders.
The researchers also identified limitations involving study quality, sample sizes, and long-term follow-up.
Has EMDR Been Studied for Different Types of Drug Addiction?
Research involving EMDR and substance use disorders has included people experiencing difficulties with different substances.
Some studies have investigated addiction-focused EMDR in mixed treatment populations rather than examining one drug exclusively.
This allows researchers to investigate craving-related outcomes across different substance use histories.
However, it makes it more difficult to determine whether EMDR works differently for opioid, stimulant, or cannabis use disorders.
Different drugs affect the body and brain in different ways.
For example, opioid dependence may involve withdrawal symptoms and physical dependence that require specific medical treatment.
Stimulant use disorders may involve different patterns of craving and behavioral reinforcement.
Researchers therefore need studies examining individual substance categories to clarify how EMDR applications may differ.
Current findings support studying EMDR across substance use disorders, but they do not establish identical outcomes for every drug.
Can EMDR Help With Substance-Related Triggers?
A trigger is a situation, experience, thought, or emotion associated with an urge to use drugs.
Triggers can include particular places, social situations, memories, or emotional states.
Some addiction-focused EMDR approaches involve identifying memories or mental images associated with craving.
For example, someone may associate a particular environment with previous drug use.
Researchers have investigated whether focusing on these memories while engaging in bilateral stimulation can reduce their vividness or emotional intensity.
This approach is related to theories involving working memory.
Working memory refers to the mental resources used to temporarily hold and manage information.
Performing eye movements while recalling a substance-related image may compete for those resources and change how the image is experienced.
However, the precise processes responsible for craving reduction remain under investigation.
How Does EMDR Compare With Other Addiction Treatments?
Drug addiction treatment commonly includes behavioral therapy, medications, recovery support, and structured treatment programs.
CBT helps people identify substance-related patterns and develop coping strategies.
Contingency management uses positive reinforcement to encourage recovery-related behaviors and has particularly strong support for stimulant use disorders.
Medications are central to treatment for certain conditions, especially opioid use disorder.
The United States Centers for Disease Control and Prevention recognizes methadone, buprenorphine, and naltrexone as medication options for opioid use disorder.
Medication treatment, particularly methadone and buprenorphine, is associated with reduced overdose risk and mortality.
EMDR addresses different aspects of addiction-related difficulties.
It may be incorporated alongside established treatments when trauma-related distress, emotional symptoms, or substance-related memories are relevant.
However, EMDR is not a substitute for appropriate medication treatment for opioid dependence.
Can EMDR Be Combined With Other Therapies?
Yes. EMDR has been studied as an additional component of existing addiction treatment programs.
For example, the 2023 pilot trial combined addiction-focused EMDR with CBT.
Other research has examined EMDR alongside routine outpatient addiction services.
A 2020 randomized trial by Markus and colleagues studied 109 adults receiving treatment for alcohol use disorder.
Participants received either standard outpatient treatment or standard treatment plus seven sessions of addiction-focused EMDR.
The trial did not find a significant additional benefit from EMDR for drinking behavior.
Although that study focused on alcohol rather than drug addiction, it demonstrates why researchers evaluate combined treatment approaches carefully.
Adding another therapy does not automatically lead to better outcomes.
Researchers examine whether the additional intervention produces measurable benefits beyond those associated with existing treatment.
What Outcomes Do Researchers Measure?
Clinical studies examine several outcomes when evaluating EMDR for addiction.
Craving intensity: Whether participants experience changes in their desire to use substances.
Substance use: Whether the frequency or quantity of drug use changes.
Addiction severity: Whether broader substance-related difficulties improve.
Trauma symptoms: Whether participants experience reductions in PTSD symptoms.
Emotional functioning: Whether anxiety, depression, or emotional distress changes.
Treatment participation: Whether participants complete sessions and remain engaged.
Longer-term outcomes: Whether improvements continue after treatment ends.
These outcomes provide different information.
A person may experience fewer cravings while continuing to have difficulties with substance use.
Similarly, improvements in PTSD symptoms do not automatically establish recovery from addiction.
Researchers therefore distinguish between psychological improvements and changes in substance-related behavior.
What Are the Limitations of the Research?
Although research findings are informative, several limitations remain.
First, some studies have small samples, making treatment differences difficult to identify reliably.
Second, addiction-focused EMDR protocols vary across studies.
Third, some research includes mixed substance use populations, limiting conclusions about individual drugs.
Fourth, treatment comparisons differ. Some studies compare EMDR with another therapy, while others examine EMDR added to existing care.
Finally, long-term follow-up evidence remains limited.
The 2025 meta-analysis also noted concerns about the methodological quality of several included studies.
These limitations explain why improvements in cravings and emotional symptoms cannot automatically be interpreted as proof of lasting addiction recovery.
What Can Be Concluded About EMDR for Drug Addiction?
EMDR is used to address several psychological concerns associated with drug addiction, including trauma-related distress, substance-related memories, and cravings.
Clinical studies and meta-analyses have reported improvements in craving intensity and emotional symptoms among people with substance use disorders.
However, research findings concerning overall addiction severity and additional benefits beyond established treatments have been less consistent.
EMDR may be particularly relevant when traumatic experiences or distressing memories contribute to substance-related difficulties.
It can also be incorporated into broader treatment approaches alongside behavioral therapies and appropriate medical care.
Overall, research supports EMDR as a potentially useful component of addiction treatment, while further studies can clarify its effects on different drugs, sustained substance use reduction, and longer-term recovery.
References
Martínez-Fernández, D. E., et al. (2024). The effect of eye movement desensitization and reprocessing (EMDR) therapy on reducing craving in populations with substance use disorder: A meta-analysis. Brain Sciences, 14(11), 1110. https://doi.org/10.3390/brainsci14111110
Seok, J.-W., Kim, K., & Kim, J. U. (2025). Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: A meta-analysis of addiction-related and emotional symptoms. Frontiers in Psychiatry, 16, 1660046. https://doi.org/10.3389/fpsyt.2025.1660046
Feasibility and efficacy of addiction-focused eye movement desensitization reprocessing in adults with substance use disorder. (2023). https://doi.org/10.1080/26408066.2023.2271927
Markus, W., et al. (2020). Addiction-focused eye movement desensitization and reprocessing therapy as an adjunct to regular outpatient treatment for alcohol use disorder: Results from a randomized clinical trial. Alcoholism: Clinical and Experimental Research, 44(1), 272–283. https://doi.org/10.1111/acer.14249
Logsdon, E., Cornelius-White, J. H. D., & Kanamori, Y. (2023). The effectiveness of EMDR with individuals experiencing substance use disorder: A meta-analysis. Journal of EMDR Practice and Research, 17(1). https://doi.org/10.1891/EMDR-2022-0046
Centers for Disease Control and Prevention. (2024). Opioid use disorder: Treating. https://www.cdc.gov/overdose-prevention/hcp/clinical-care/opioid-use-disorder-treating.html
Substance Abuse and Mental Health Services Administration. (2024). Medications for opioid use disorder: Treatment Improvement Protocol 63. https://www.samhsa.gov/resource/ebp/tip-63-medications-opioid-use-disorder
