Cue reactivity

Cue reactivity is the physiological and emotional response, including craving, that a person with a substance use history shows when exposed to reminders of that substance.

Cues can be the sight or smell of alcohol or cigarettes, drug paraphernalia, familiar places and people, times of day, or internal states such as stress and low mood. Through repeated pairing, these cues acquire the ability to trigger anticipation and craving, accompanied by measurable changes in heart rate, skin conductance and brain activity in reward regions such as the striatum. Cue reactivity persists long into abstinence and is a well-documented predictor of return to use.

In research it is studied by presenting standardized cues, such as images, videos or handling the substance, and recording craving ratings and physiological responses, often with functional brain imaging. This laboratory model is used to test whether a treatment can dampen the response before larger clinical trials are run. Cannabinoids, and CBD in particular, have been studied in cue reactivity paradigms for tobacco, opioid and cannabis use in small early trials; the findings are preliminary and no such product has an approved use.