Case Report
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Abstract
This article presents the first experiences of using eye movement desensitization and reprocessing (EMDR) therapy to aid in the treatment of gamma-hydroxybutyric acid (GHB) dependency. A case presented itself as a result of intense, treatment-resistant cravings despite pharmacological treatment. The patient received 7 weekly sessions using a subset of the palette of EMDR interventions in addiction (PEIA; Markus & Hornsveld, 2017) targeting both negative and positive valenced addiction-related memory representations from the past, present, and future. Patient-reported GHB craving showed a gradual and prolonged reduction. Urine samples showed that the patient remained abstinent during and at least 6 months after EMDR therapy. Further research regarding the effectiveness of EMDR therapy in this particularly challenging group of substance users is warranted.
Figures
FIGURE 1.
Changes in pre- and posttreatment levels of subjective craving over the course of seven EMDR therapy sessions.
View in ContextTables
TABLE 1.
Specifics of Activated Targets During EMDR Therapy
| Session | Image | Threshold-Lowering Thought | PC | VoC(1–7) | Emotions | LoU/LoPA(0–10) | Body Location |
|---|---|---|---|---|---|---|---|
| 1 | Alone at home, dosing a GHB “fix” | “When I use GHB, my life is much more fun” | “I don’t need the GHB, I can handle this” | 2 | Unrest | 9 (LoU) | Stomach and hands |
| 2 | In the living room, listening to music with friends from the drug scene. Holding a syringe, dosing the GHB before taking it | “I’m a nicer person using GHB” | “I can handle this (without GHB)” | 2 | Cheerful |
| Stomach and hands |
| 3 | Sitting next to the car’s driver, having fun with friends while holding a dose of GHB, on the verge of swallowing it | “If I use GHB, I’m enjoying life more” | “I can handle this” | 5 | Cheerful |
| Stomach and hands |
| 4 | (Going “back to target” of Session 2): in the living room, listening to music with two friends from the drug scene. Holding a syringe, dosing the GHB | — | — | — | — |
| — |
| 5 | Sitting alone on the bed, listening to hardcore music whilst under the influence of GHB | “I feel great with GHB” | “I can feel good without GHB” | 3 | Happy and satisfied |
| Hands, legs, and head |
| 6 | Sitting on a sofa with GHB on the table in front of her | “If I take GHB I feel great again” | “I can resist GHB, even when it’s in front of me” | 5 | Anxiety mixed witha thrill of pleasure |
| Arms, hands, and legs |
| 7 | Sitting with GHB in front of her | “Using GHB would be very nice” | “I can handle this” | 4 | Excited but also disappointed |
| Hands, legs, and stomach |
Note. PC = positive cognition; VoC = validity of cognition; LoU = level of urge; LoPA = level of positive affect; GHB = gamma-hydroxybutyric acid.
Article usage
| Period | Abstract | Full | Total | |
|---|---|---|---|---|
| Apr 2024 | 33 | 12 | 4 | 49 |
| Mar 2024 | 28 | 16 | 3 | 47 |
| Feb 2024 | 39 | 12 | 3 | 54 |
| Jan 2024 | 65 | 13 | 7 | 85 |
| Dec 2023 | 25 | 6 | 0 | 31 |
| Nov 2023 | 28 | 13 | 6 | 47 |
| Oct 2023 | 31 | 6 | 2 | 39 |
| Sep 2023 | 38 | 6 | 0 | 44 |
| Aug 2023 | 16 | 4 | 2 | 22 |
| Jul 2023 | 27 | 3 | 2 | 32 |
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| May 2023 | 26 | 12 | 7 | 45 |
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| Mar 2023 | 39 | 24 | 6 | 69 |
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| Dec 2022 | 43 | 12 | 6 | 61 |
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| May 2022 | 34 | 15 | 5 | 54 |
| Apr 2022 | 37 | 15 | 7 | 59 |
| Mar 2022 | 30 | 12 | 6 | 48 |
| Feb 2022 | 17 | 10 | 6 | 33 |
| Jan 2022 | 22 | 12 | 7 | 41 |
| Dec 2021 | 18 | 9 | 1 | 28 |
| Nov 2021 | 27 | 19 | 2 | 48 |
| Oct 2021 | 25 | 11 | 1 | 37 |
| Sep 2021 | 26 | 19 | 6 | 51 |
| Aug 2021 | 17 | 4 | 1 | 22 |
| Jul 2021 | 11 | 10 | 4 | 25 |
| Jun 2021 | 31 | 30 | 7 | 68 |
| May 2021 | 61 | 17 | 14 | 92 |
| Apr 2021 | 55 | 23 | 7 | 85 |
| Mar 2021 | 39 | 21 | 6 | 66 |
| Feb 2021 | 65 | 17 | 4 | 86 |
| Jan 2021 | 267 | 27 | 4 | 298 |
| Dec 2020 | 87 | 19 | 3 | 109 |
| Nov 2020 | 53 | 16 | 7 | 76 |
| Oct 2020 | 59 | 16 | 5 | 80 |
| Sep 2020 | 50 | 11 | 6 | 67 |
| Aug 2020 | 19 | 14 | 5 | 38 |
| Jul 2020 | 26 | 9 | 4 | 39 |
| Jun 2020 | 17 | 9 | 5 | 31 |
| May 2020 | 28 | 7 | 3 | 38 |
| Apr 2020 | 47 | 6 | 7 | 60 |
| Mar 2020 | 64 | 10 | 10 | 84 |
| Feb 2020 | 83 | 8 | 4 | 95 |
| Jan 2020 | 183 | 18 | 5 | 206 |
| Dec 2019 | 30 | 9 | 3 | 42 |
| Nov 2019 | 34 | 5 | 1 | 40 |
| Oct 2019 | 29 | 11 | 4 | 44 |
| Sep 2019 | 17 | 1 | 0 | 18 |
| Aug 2019 | 2 | 2 | 2 | 6 |
| Jul 2019 | 4 | 14 | 5 | 23 |
| Jun 2019 | 12 | 7 | 14 | 33 |
| May 2019 | 11 | 11 | 11 | 33 |
| Apr 2019 | 9 | 6 | 1 | 16 |
| Mar 2019 | 11 | 28 | 3 | 42 |
| Feb 2019 | 10 | 15 | 6 | 31 |
| Jan 2019 | 9 | 11 | 7 | 27 |
| Dec 2018 | 26 | 3 | 1 | 30 |
| Nov 2018 | 8 | 0 | 0 | 8 |
| Oct 2018 | 14 | 1 | 2 | 17 |
| Sep 2018 | 11 | 1 | 1 | 13 |
| Aug 2018 | 8 | 0 | 0 | 8 |
| Jul 2018 | 15 | 1 | 1 | 17 |
| Jun 2018 | 1 | 0 | 1 | 2 |
| May 2018 | 2 | 1 | 2 | 5 |
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