Addiction cravings ease after music therapy

Clinical takeaway: Music therapy may give patients in treatment short-term respite from craving, but this early study doesn't show it carries beyond each session. 

Craving is a central symptom of substance use disorder, and patients in community treatment have to manage it in their everyday lives, outside the structure of residential or inpatient care. A 2019 World Health Organization report on the arts and health counted substance use disorder among the conditions music therapy may benefit. 

Results have varied across pilot studies, case reports, cohort studies, and randomized trials, and few have followed patients in community services, where music therapy runs alongside ordinary treatment. Brain-based evidence from those settings is scarce, which leaves the mechanism behind any benefit untested. This pilot study tests music therapy as an add-on, pairing craving scales and interviews with brain recordings. 

Immediate craving appeared to ease after individual music therapy sessions. On a 0-to-10 scale measuring craving “right now,” participant averages fell from 1.75 before sessions to 0.88 afterward. However, only the music therapy group completed this measure, and just 31 of 60 possible before-and-after pairs were returned.

That improvement did not carry over to a separate measure of craving over the previous 24 hours. Scores on that measure rose from 2.6 to 4.2 in the music therapy group and fell from 5.8 to 2.5 with usual treatment; after adjustment for baseline differences, however, the difference between groups was not statistically significant. Frontal beta activity, an EEG marker associated with craving, likewise showed no significant between-group difference. Depression and anxiety questionnaires showed no group differences.

Frontal alpha asymmetry, an EEG measure of emotional processing, differed between groups at two of three electrode pairs after baseline adjustment. This exploratory comparison rested on nine music therapy and four usual-treatment recordings. 

In this partly randomized, unblinded pilot, 10 of 16 adults at a London community substance use treatment service received six weekly music therapy sessions on top of usual treatment, and the rest received usual treatment alone. Craving, brain activity, and mood were measured at the start and in week eight. 

The authors call for a larger trial that tests whether in-session relief translates into sustained outcomes, which would mean following patients beyond eight weeks and comparing music therapy against an attention-matched control rather than usual treatment alone. They also want allocation rules set before recruitment so every participant stays eligible for every arm, along with systematic tracking of how much usual treatment each patient receives. Feasibility and implementation results from the pilot's parent trial will be reported in a separate publication. 

"Overall, it provides encouraging evidence for the role of music therapy in addiction treatment and supports the value of combining psychometric, qualitative and EEG measures when studying music therapy in substance use disorders," said Jorg Fachner, professor of music, health and the brain at Anglia Ruskin University and senior author of the study. "However, given the small sample size of this pilot study, the trends we found require confirmation in longer and larger-scale investigations." 

Source: Pasqualitto F, et al. (2026 Sep 10) Addict Neurosci. Music therapy in community-based substance misuse treatment: Exploring psychometric, qualitative and EEG measures related to craving, inhibition and affective processing