EMDR for Addiction and Cravings

A lot of people who can’t stop using are not, underneath it, chasing a high. They’re trying to shut something off. A memory that won’t stay buried, a dread that climbs when the day goes quiet, a feeling they’ve never had words for. The drink or the pill works, briefly, because it does what nothing else has: it makes the noise stop. That’s the trap, and it’s also the opening EMDR is built to work in.

EMDR for addiction starts from a link the research keeps confirming: trauma and substance use travel together, and a great deal of using is an attempt to numb pain that was never processed. EMDR is a trauma therapy that works on that pain directly. It is rarely the whole plan, and it usually isn’t a standalone, but as a way to drain the power out of what’s driving the using, it has real and growing promise.

Why Trauma and Addiction Run Together

Start with how often the two sit in the same person. Substance use disorders and post-traumatic stress disorder co-occur far more often than chance would predict, and the overlap is too large and too consistent to be coincidence^[5]. Among people in addiction treatment, post-traumatic symptoms are common, which is exactly why clinicians began reaching for trauma-focused tools in the first place^[1].

The most familiar explanation is the self-medication model: people drink or use to quiet the distress of trauma. The relief is real in the short term, which is what makes it so sticky. A systematic review finds genuine support for this drinking-to-cope pattern, while also noting the science is messier than the tidy story suggests—self-medication is part of the picture, not the whole of it^[6]. There’s also evidence the link runs in more than one direction: shared genetic and neurobiological vulnerabilities may predispose some people to both conditions at once, so it isn’t always a simple case of one causing the other^[5].

You can see the pattern even in the specifics. Among adolescents in addiction treatment, those with probable PTSD reported more frequent use of certain substances than peers without trauma, and the substance use tended to begin after the post-traumatic symptoms did—the order you’d expect if using were a way to cope^[7]. And in adults treated for both conditions at once, lower PTSD symptoms at the end of treatment were linked to less substance use afterward, which is exactly what the self-medication idea would forecast^[8].

This is the gap EMDR is meant to fill. Standard addiction treatment and relapse prevention can move past the role unresolved trauma plays, and adding trauma work has been proposed as a way to close it^[9]. The logic is direct: if a substance is quieting pain, then helping the brain finally process that pain can loosen the pull toward using.

How EMDR Reprocesses the Pain Underneath

EMDR is, first and foremost, a therapy for trauma. While you briefly hold a difficult memory in mind, the therapist guides you through bilateral stimulation—usually side-to-side eye movements, sometimes taps or tones. The aim is to help the brain reprocess the memory so it loses its charge: the event still happened, but it stops grabbing you in the present. It follows a careful, staged structure—the full eight phases of EMDR put safety and stabilization first, long before any hard memory is approached.

Applied to addiction, the most common approach is straightforward: use standard EMDR to process the traumatic memories sitting beneath the substance use. The bet is that as those memories settle, the need to numb them eases, and the urge to use eases with it^[2].

Early studies have tested exactly this. In a small pilot, people with alcohol or drug dependence who got standard EMDR added to their usual treatment showed a significant drop in PTSD symptoms compared with usual treatment alone^[2]. Women in long-term recovery, in a separate study, described EMDR helping them finally work through the trauma that ordinary relapse-prevention work had left untouched^[9]. The samples are small, but the direction is consistent and hopeful.

Protocols That Target the Craving Itself

The second approach is more specialized, and more interesting if cravings are what’s beating you. Instead of starting with an old trauma, these protocols point the same reprocessing engine straight at the addiction—at the memories, triggers, and urges that fire a craving here and now.

One named method is DeTUR—desensitization of triggers and urge reduction. Rather than a trauma, it works through a ranked list of the situations that set off the urge, using bilateral stimulation to bring that urge down. It’s been tried in small studies for behavioral addictions: a case series applied DeTUR to pathological gambling^[10], and a case report used the same trigger-and-urge approach for the avoidance at the core of a phobia^[11]. These are early, small reports, not large trials—but they show the protocol working.

The broader version is addiction-focused EMDR, which treats the memories that drive cravings as targets in their own right. It’s been studied as an add-on for substance use disorder, including a pilot testing its effect on cravings and addiction-related thinking^[3], and a randomized trial that added seven sessions of addiction-focused EMDR to standard outpatient care for alcohol use disorder^[12]. EMDR has also been folded into multi-part programs—one heroin-dependence study combined motivational interviewing, coping-skills training, EMDR, and mindfulness into a single intervention with long-term follow-up^[13]. In those blended programs EMDR is one ingredient among several, so the results belong to the whole recipe, not to EMDR alone.

What the Evidence Actually Says for Addiction

Here’s where being straight with you matters most, because EMDR for addiction is a genuinely young field and it would be easy to oversell.

The encouraging part is real. A recent meta-analysis pooled the available studies to examine EMDR’s effect on addiction-related symptoms like craving and severity, alongside the trauma, depression, and anxiety that so often come with substance use disorders^[4]. That such a review now exists is a genuine milestone for the field. But much of the evidence base still rests on pilots, case series, and study protocols rather than large completed trials—several rigorous randomized trials have been mounted specifically to pin down whether EMDR reduces substance use and craving^[14][15]. Trauma-focused therapies including EMDR have also been compared head-to-head with approaches like prolonged exposure for people with co-occurring PTSD and substance use, work that is still maturing^[16].

The takeaway: real promise, growing science, not yet the settled certainty that surrounds EMDR for PTSD or cognitive behavioral therapy for addiction. If trauma is part of your story, that’s a reason to ask about EMDR—not a reason to drop everything else.

Who EMDR Fits, and What It Pairs With

EMDR tends to fit people whose using is tangled up with trauma—the ones for whom the substance has always felt like a way to manage something older and more painful. If that’s you or someone you love, a trauma-focused approach is worth asking about.

It is almost never the whole plan, and that’s by design. EMDR is studied and used as an add-on, layered onto standard addiction treatment rather than replacing it^[1]. The strongest setups combine it with the rest of a real recovery plan.

• Skills-based therapy. EMDR works on the “why,” while cognitive behavioral therapy builds the day-to-day skill of spotting triggers and reshaping the thoughts that drive use, and dialectical behavioral therapy teaches the distress-tolerance moves that carry you through a craving. The grounding skills DBT teaches pair especially well with trauma work.
• Medication. For opioid and alcohol use disorder especially, medication for addiction is a core part of treatment that EMDR can sit alongside, not compete with.
• The wider trauma frame. EMDR is one branch of trauma-focused therapy, and which branch fits best is a conversation worth having with a clinician.

The freeing part is that you don’t have to choose the one perfect therapy. If trauma is part of your story, EMDR can be a meaningful piece of a fuller plan—and the way out of using is almost always easier than the agony you’re picturing when you imagine stopping.

A Path Worth Asking About

If using has become the only thing that turns the pain down, the idea that the pain itself can be processed and set down is not wishful thinking. It’s the whole premise of a therapy with a strong record for trauma and growing promise for addiction. You don’t have to keep numbing a wound that can actually heal.

You also don’t have to sort this out alone. A clinician who understands both trauma and addiction can tell you whether EMDR fits your situation and how it would sit alongside the rest of your care. Find treatment and people who can help →

Written by

Jessica Miller

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

Reviewed by

• Fact-Checked
• Editor

Kent S. Hoffman, D.O.

Co-Founder & Chief Medical Officer

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.