Behavioral therapies targeting reward mechanisms in substance use disorders

• Published in: Pharmacology, biochemistry and behavior Vol. 240; p. 173787
• Main Authors: Wardle, Margaret C., Webber, Heather E., Yoon, Jin H., Heads, Angela M., Stotts, Angela L., Lane, Scott D., Schmitz, Joy M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2024
• Subjects: Acceptance and commitment therapy; Attentional bias modification; Behavioral activation; Behavioral therapy; Cognitive behavioral therapy; Contingency management; Episodic future thinking; Mindfulness-oriented recovery enhancement; Reward; Episodic future thinking; Behavioral therapy; Attentional bias modification; Acceptance and commitment therapy; Contingency management; Cognitive behavioral therapy; Mindfulness-oriented recovery enhancement; Reward; Behavioral activation
• ISSN: 0091-3057; 1873-5177; 1873-5177
• DOI: 10.1016/j.pbb.2024.173787

Behavioral therapies are considered best practices in the treatment of substance use disorders (SUD) and used as first-line approaches for SUDs without FDA-approved pharmacotherapies. Decades of research on the neuroscience of drug reward and addiction have informed the development of current leading behavioral therapies that, while differing in focus and technique, have in common the overarching goal of shifting reward responding away from drug and toward natural non-drug rewards. This review begins by describing key neurobiological processes of reward in addiction, followed by a description of how various behavioral therapies address specific reward processes. Based on this review, a conceptual ‘map’ is crafted to pinpoint gaps and areas of overlap, serving as a guide for selecting and integrating behavioral therapies. •Many theories posit addiction as a disorder of reward.•Correspondingly, behavior therapies for addiction operate on reward mechanisms.•The neurobiology of reward reveals there are several separable reward processes.•We examine which reward processes are addressed by behavior therapies for addiction.