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Cocaine Cues Used in Experimental Research: A Systematic Review

Brobbin, Eileen, Lowry, Natalie, Cella, Matteo, Copello, Alex, Coulton, Simon, Di Pietro, Jerome, Drummond, Colin, Glautier, Steven, Kiyak, Ceyda, Phillips, Thomas, and others. (2025) Cocaine Cues Used in Experimental Research: A Systematic Review. Brain Sciences, 15 (6). Article Number 626. ISSN 2076-3425. (doi:10.3390/brainsci15060626) (KAR id:110261)

Abstract

Cue exposure therapy (CET) is a promising treatment approach for cocaine substance use disorder (SUD). CET specifically targets the psychological and physiological responses elicited by drug-related cues, aiming to reduce their motivational impact. To advance understanding of CET for cocaine treatment, this systematic review aims to categorise the range of cocaine cues used in research. Methods: A systematic review of the existing literature with searches conducted on PubMed and Web of Science bibliographic databases with no time constraints in August 2024 (PROSPERO: CRD42024554361). Three reviewers were independently involved in the screening, review and data extraction process, in line with PRISMA guidelines. Data extracted included participant demographics, study design, data on the cocaine cue task, and examples (if provided). Each study was appraised and received a quality score. The secondary outcome was to summarise examples for each category type identified. The data are presented as a narrative synthesis. Results: 3600 articles were identified and screened. 235 articles were included in the analysis. Cues identified included images, paraphernalia, drug-related words, cocaine smell, auditory stimuli presented via audiotapes, video recordings, scripts, and virtual reality environments, often combining multiple modalities. Included studies recruited cocaine-dependent individuals, recreational users, polydrug users, and non-cocaine-using controls. The sample sizes of the studies ranged from a single case study to a study including 1974 participants. Conclusions: This review found that studies employed a wide range of cue categories, but detailed examples were often lacking, limiting replication. The number and combination of cues varied: some studies used only cocaine-related images, while others included images, videos, physical items, and audiotapes. The level of immersion and personalisation also differed considerably. All studies used cocaine-specific cues, most commonly images or representations of cocaine substance, cocaine use or drug paraphernalia, drug preparation items, or conversations of cocaine use and its effects. The overall quality of the included studies was deemed good, with all adhering to standard research norms. While this review highlights the breath of cue types used in the literature, further research should focus on enhancing cue exposure techniques by incorporating more immersive and personalised stimuli, and by providing clearer documentation of cue characteristics to support replication and clinical translation.

Item Type: Article
DOI/Identification number: 10.3390/brainsci15060626
Uncontrolled keywords: cocaine-cue reactivity; cue exposure therapy; cue-induced cocaine craving; cue reactivity; cocaine; cocaine dependence; cocaine treatment
Subjects: R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine
Institutional Unit: Schools > School of Social Sciences > Centre for Health Services Studies
Former Institutional Unit:
There are no former institutional units.
Funders: National Institute for Health Research (https://ror.org/0187kwz08)
Depositing User: Simon Coulton
Date Deposited: 11 Jun 2025 11:10 UTC
Last Modified: 02 Jul 2025 10:24 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/110261 (The current URI for this page, for reference purposes)

University of Kent Author Information

Coulton, Simon.

Creator's ORCID: https://orcid.org/0000-0002-7704-3274
CReDIT Contributor Roles: Conceptualisation, Writing - review and editing, Methodology, Funding acquisition
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