EMDR for Addiction and Cravings: What Have Researchers Studied?
Eye Movement Desensitization and Reprocessing (EMDR) is commonly associated with trauma treatment, but researchers have also studied it in people with addictions and Substance Use Disorders (SUDs).
This research has taken several different forms.
Some studies use standard EMDR to treat traumatic memories in people who also have a substance use problem. Others use addiction-focused EMDR, which targets memories, images, urges, or cues connected more directly with craving and substance use.
Researchers have measured outcomes such as:
craving;
amount or frequency of substance use;
addiction severity;
relapse;
Post-Traumatic Stress Disorder (PTSD) symptoms;
depression;
anxiety;
and thoughts or memories connected with substance use.
The overall findings are mixed in an important way.
Recent meta-analyses find that EMDR is associated with meaningful reductions in craving and in PTSD, depression, and anxiety symptoms among people with Substance Use Disorders.
However, pooled research has not found the same clear effect on overall addiction severity, and individual randomized trials have not consistently shown that adding addiction-focused EMDR reduces actual substance use more than established addiction treatment alone. PubMed Central (PMC)
So the research does not support reducing the question to either “EMDR works for addiction” or “EMDR does not work for addiction.”
A more useful conclusion is that EMDR has been studied for several different parts of addiction—especially craving, substance-related memories, trauma symptoms, and co-occurring emotional difficulties—and the results vary depending on what researchers measure.
What Do Researchers Mean by “Addiction” in These Studies?
Addiction research covers several different conditions.
Many EMDR studies involve people with a diagnosed Substance Use Disorder involving substances such as:
alcohol;
nicotine;
cocaine;
opioids;
or multiple drugs.
Some studies examine people receiving residential addiction treatment, while others involve outpatient treatment.
Researchers also distinguish between several outcomes that are easy to lump together but are not the same.
Craving refers to the urge or desire to use a substance.
Substance use measures what people actually consume—such as number of drinks, days of use, or abstinence.
Addiction severity may combine several aspects of substance use and its effects on a person's life.
Relapse generally refers to returning to substance use after a period of reduction or abstinence.
An intervention might improve one of these outcomes without improving all of them.
That distinction is central to understanding the EMDR research.
Why Have Researchers Focused So Much on Craving?
Craving is closely connected with memories and cues.
A person may experience a strong urge after seeing a familiar place, remembering a previous period of use, imagining the effects of a substance, or encountering another cue associated with past use.
Researchers have therefore proposed that some addiction-related memories may become targets for EMDR.
In addiction-focused EMDR, a person may bring to mind:
a particularly strong craving experience;
an image of using the substance;
a memory associated with rewarding effects;
a feared future relapse;
or another substance-related image or memory.
Eye movements or another dual-attention task are then used while that material is held in mind.
The underlying idea overlaps with the working-memory research discussed in What Is the Working-Memory Theory of EMDR? If an emotionally or motivationally powerful image becomes less vivid or less intense, the craving connected with it may also decrease.
That is a plausible mechanism, but the clinical question still has to be tested directly: Do cravings actually decline in treatment studies?
What Do Meta-Analyses Say About Craving?
The most consistent addiction-related finding concerns craving.
A 2024 meta-analysis focused specifically on craving in people with Substance Use Disorders. It included five studies with 266 participants.
Across those studies, EMDR was associated with a significant reduction in craving compared with control conditions. The random-effects analysis found a large overall effect, although there was meaningful variation between studies. PubMed Central (PMC)
The studies differed in:
substance being used;
EMDR protocol;
session length;
number of sessions;
and comparison treatment.
That variation matters because it makes the exact size of the effect less certain.
Still, the overall direction was clear enough for the authors to conclude that EMDR may have meaningful effects on craving.
What Did the Larger 2025 Meta-Analysis Find?
A broader 2025 meta-analysis examined 14 studies of EMDR in people with Substance Use Disorders.
Instead of looking only at craving, it examined several different outcomes:
craving;
addiction severity;
PTSD symptoms;
depression;
and anxiety.
The results were revealing.
EMDR was associated with statistically significant improvements in:
craving, with a moderate effect;
PTSD symptoms;
depression;
and anxiety.
However, the effect on overall addiction severity was not statistically significant. PubMed Central (PMC)
This is one of the most important findings in the current literature.
It suggests that EMDR may meaningfully affect some components of addiction, especially craving and emotional symptoms, without automatically producing an equally strong change in every measure of substance-use severity.
That is why “Does EMDR work for addiction?” is too broad a question.
Researchers need to specify which addiction outcome they mean.
Does Reducing Craving Mean Someone Uses Less?
Not necessarily.
Craving and substance use are related, but they are not identical.
A person may report less urge to use but still have established habits, environmental cues, social influences, or other factors affecting actual substance use.
This distinction appears clearly in one of the larger randomized trials.
A 2020 study involved 109 adults with Alcohol Use Disorder receiving standard outpatient addiction treatment.
Participants were randomly assigned to:
treatment as usual alone;
or treatment as usual plus seven weekly sessions of addiction-focused EMDR.
The researchers measured actual drinking behavior as the primary outcome.
They found no significant added benefit of addiction-focused EMDR on alcohol consumption compared with standard treatment alone.
There were some indications of reduced craving in the EMDR group, but the primary drinking outcomes did not improve more. PubMed
That trial is a good example of why craving reduction cannot automatically be described as recovery from addiction.
What About Smaller Addiction-Focused EMDR Trials?
Smaller trials have produced similarly mixed but informative findings.
A 2024 pilot randomized trial included 30 people with Substance Use Disorders receiving either:
Cognitive Behavioral Therapy alone;
or Cognitive Behavioral Therapy plus four sessions of addiction-focused EMDR.
Both groups showed significant reductions in craving, repetitive addiction-related thinking, and irrational addiction-related beliefs.
However, the researchers found no significant difference between the groups.
The study did show that the EMDR intervention was feasible and that almost all participants completed the sessions. But because both groups improved, the trial could not establish that adding EMDR produced a greater effect than Cognitive Behavioral Therapy alone. PubMed
This is why larger controlled trials are useful even when smaller studies appear encouraging.
They help determine how much improvement comes specifically from EMDR rather than from addiction treatment more generally.
Has Standard EMDR Been Used to Treat Trauma in People With Addiction?
Yes, and this is a somewhat different research question.
Many people with Substance Use Disorders also have histories of traumatic experiences or meet criteria for PTSD.
Researchers have therefore studied whether standard trauma-focused EMDR can be provided while someone is also receiving addiction treatment.
A small pilot randomized study included 12 people with chronic alcohol or drug dependence.
Participants received either treatment as usual or treatment as usual plus eight sessions of standard EMDR focused on traumatic memories.
The EMDR group showed significant reductions in PTSD symptoms and depression, but the study did not find a significant reduction in addiction symptoms. PubMed
Again, this demonstrates that different outcomes can move in different directions.
EMDR may improve trauma-related distress without necessarily changing substance use by the same amount.
Why Does Treating Trauma Matter in Addiction Research?
PTSD and Substance Use Disorders frequently occur together.
For some people, trauma symptoms and substance use appear closely connected. Distressing memories, anxiety, sleep disturbance, or reminders of past experiences may contribute to substance use or craving.
Researchers have therefore asked whether treating PTSD directly can improve outcomes in people who also have a Substance Use Disorder.
A large randomized trial published in 2025 included 209 people with both PTSD and a Substance Use Disorder.
Participants received regular substance-use treatment either alone or combined with one of three trauma-focused treatments:
Prolonged Exposure;
EMDR;
or Imagery Rescripting.
EMDR significantly reduced PTSD symptoms when provided alongside addiction treatment, and the broader trial showed that trauma-focused treatment could be provided at the same time as substance-use treatment rather than necessarily waiting until substance treatment had been completed. PubMed
A follow-up analysis published in 2026 found no significant differences in Substance Use Disorder outcomes between the three trauma-focused treatments, but EMDR remained an effective option for treating the co-occurring PTSD. ScienceDirect
This distinction is important:
Treating PTSD successfully in someone who also has an addiction is not the same as proving that EMDR directly treats the addiction itself.
Both findings can still be clinically meaningful.
Does EMDR Have to Be Delayed Until Substance Use Improves?
Recent research does not support making that a universal rule.
In the 209-person randomized trial, researchers compared trauma treatment provided simultaneously with Substance Use Disorder treatment against trauma treatment provided sequentially, after the initial substance-use treatment period.
At three months, simultaneous treatment produced faster PTSD improvement and was preferred by most participants. Over the longer follow-up, there were no significant differences between the timing approaches in PTSD severity.
The researchers concluded that delaying PTSD treatment until Substance Use Disorder treatment is completed is not necessary. ScienceDirect
That finding concerns people with co-occurring PTSD and Substance Use Disorder.
It does not mean every addiction treatment needs to include EMDR.
It means that the presence of a Substance Use Disorder does not automatically exclude someone from benefiting from trauma-focused EMDR when PTSD is also present.
What About Nicotine Craving?
Researchers have also conducted laboratory studies involving smoking.
One randomized experiment included 47 daily smokers who had abstained overnight.
Participants recalled craving-related memories while either making eye movements or keeping their gaze fixed.
The study examined whether working-memory competition could reduce the vividness of addiction-related memories and nicotine craving.
The results suggested temporary effects on memory vividness and craving, although they did not establish a lasting smoking-cessation effect. PubMed
Studies like this are useful for investigating mechanisms.
They help researchers test whether craving-related memories can be altered through the same working-memory processes studied with distressing autobiographical memories.
But a brief laboratory reduction in craving is not the same as showing long-term abstinence.
Why Might Addiction-Related Memories Matter?
Addiction is not driven by one process.
Biology, habit, reinforcement, environment, mood, social context, and learned cues can all play roles.
Memory is one part of that system.
Over repeated substance use, certain experiences can become strongly linked with craving or expectations of reward.
For example:
a place may trigger an urge;
an image of drinking may become highly attractive;
a memory of relief from anxiety may strengthen desire to use again;
or remembering a previous relapse may itself become emotionally charged.
Addiction-focused EMDR attempts to work with some of these memory representations.
Researchers have proposed that reducing their vividness or emotional and motivational intensity may decrease craving. A 2025 scientific commentary described this as a potentially useful direction while emphasizing the need to better understand which addiction-related memories and procedures are most important. PubMed
Does Research Show That EMDR Reduces Relapse?
The evidence here is less consistent.
Some small early studies reported lower relapse rates after addiction-focused EMDR.
For example, an early study discussed in the 2025 meta-analysis reported lower craving after treatment and a lower relapse rate at six months in the EMDR group. Frontiers
However, larger randomized research has not consistently reproduced a clear improvement in actual substance-use outcomes.
The 109-person alcohol trial found no added effect of addiction-focused EMDR on drinking behavior. PubMed
The 2025 meta-analysis likewise found no statistically significant overall effect on addiction severity. PubMed Central (PMC)
So the evidence is stronger for craving reduction than for a general claim that EMDR reduces relapse or substance use across addiction populations.
What About Depression and Anxiety?
These outcomes are important because people with Substance Use Disorders may also experience depression, anxiety, and trauma-related symptoms.
The 2025 meta-analysis found moderate effects of EMDR on:
PTSD symptoms;
depression;
and anxiety.
The effect sizes for these emotional symptoms were at least as large as the pooled effect on craving. PubMed Central (PMC)
This suggests that part of EMDR's usefulness in addiction populations may involve treating emotional difficulties that occur alongside substance use.
That does not mean those symptoms are the sole cause of addiction.
It means addiction research may benefit from looking beyond only the amount of substance used.
What Are the Main Limitations of the Research?
The research has several limitations.
First, many studies are small.
The 2024 craving meta-analysis included only five studies and 266 participants. PubMed Central (PMC)
Second, studies use different EMDR approaches.
Some use standard trauma-focused EMDR.
Others use addiction-focused protocols targeting cravings or substance-related imagery.
Third, the substances being studied differ.
Alcohol, nicotine, and mixed drug-use populations may not respond in exactly the same way.
Fourth, outcome measures vary considerably.
A study measuring craving is answering a different question from one measuring:
abstinence;
amount consumed;
relapse;
or addiction severity.
Finally, longer-term evidence remains limited.
The 2025 meta-analysis found some evidence of short-term craving reduction but described long-term treatment effects as less certain. It also rated the overall quality of the included studies as generally low. PubMed Central (PMC)
These limitations mean the evidence needs to be described precisely rather than dismissed or exaggerated.
What Can We Reasonably Conclude?
Researchers have studied EMDR in addiction from several different angles.
Craving is the clearest addiction-specific outcome so far. Two recent meta-analyses found significant reductions in craving among people receiving EMDR. PubMed Central (PMC)
The evidence for broader addiction severity and actual substance use is less consistent. A large alcohol trial found no additional reduction in drinking from adding addiction-focused EMDR to established addiction treatment, and the 2025 meta-analysis did not find a significant pooled effect on addiction severity. PubMed
EMDR also appears useful for PTSD, depression, and anxiety in people with Substance Use Disorders. PubMed Central (PMC)
And recent randomized research shows that people with both PTSD and a Substance Use Disorder can receive trauma-focused EMDR alongside addiction treatment rather than necessarily postponing trauma treatment. ScienceDirect
So the research does not point to one simple “EMDR addiction treatment effect.”
Instead, it shows that EMDR may address several different parts of the clinical picture—particularly craving, trauma-related symptoms, and associated emotional difficulties—while researchers continue examining whether and when those improvements translate into reduced substance use or relapse.
Frequently Asked Questions
Has EMDR been studied for addiction?
Yes. Researchers have studied both standard trauma-focused EMDR and addiction-focused EMDR in people with Substance Use Disorders. Outcomes have included craving, substance use, relapse, addiction severity, PTSD, depression, and anxiety.
Does EMDR reduce cravings?
Meta-analyses published in 2024 and 2025 found significant reductions in craving associated with EMDR. The 2025 analysis found a moderate overall effect. PubMed Central (PMC)
Does less craving mean less substance use?
Not automatically. A randomized trial of 109 adults with Alcohol Use Disorder found no additional reduction in drinking when addiction-focused EMDR was added to regular addiction treatment, even though some craving measures showed improvement. PubMed
Can EMDR be used when someone has both PTSD and a Substance Use Disorder?
Research has directly studied this combination. A large randomized trial found that EMDR could effectively treat PTSD while people simultaneously received Substance Use Disorder treatment. ScienceDirect
Is addiction-focused EMDR the same as standard EMDR for trauma?
Not exactly. Standard EMDR usually targets distressing or traumatic memories. Addiction-focused protocols may instead target craving-related memories, images, urges, or substance-use cues. Some studies examine both approaches.
Conclusion
EMDR research in addiction now covers much more than one question.
Researchers have studied whether EMDR can reduce craving, change substance-related memories, help with PTSD and emotional symptoms in people with addictions, and ultimately affect substance use, relapse, and addiction severity.
The strongest pooled finding so far concerns craving.
Recent meta-analyses find that EMDR is associated with significant reductions in craving, along with improvements in PTSD, depression, and anxiety symptoms among people with Substance Use Disorders. PubMed Central (PMC)
The evidence is less consistent for actual substance consumption and overall addiction severity. Larger randomized trials show that reducing craving or trauma symptoms does not automatically translate into a greater reduction in substance use than standard addiction treatment alone. PubMed
That makes the most accurate conclusion fairly specific:
EMDR has meaningful research support for reducing cravings and trauma-related or emotional symptoms in people with addictions, while researchers are still determining how reliably those changes affect substance use, relapse, and overall addiction severity over time.
