A Cluster-Randomized Trial Comparing Songwriting and Recreational Music Therapy via Craving and Withdrawal in Adults on a Detoxification Unit

Background: Craving and withdrawal can contribute to the development and maintenance of substance use disorder (SUD), relapse, and overdose. Although music therapy can positively impact craving and withdrawal in adults with SUD on a detoxification unit, there is a lack of randomized research comparing different music therapy interventions as well as studies measuring within-session changes in these critical constructs. Objective: The purpose of this effectiveness study was to compare motivational-educational songwriting (MESW) and recreational music therapy (RMT) via measures of craving and withdrawal in adults with SUD on a detoxification unit using a two-group pre- and posttest design. Method: Participants (N = 134) were cluster-randomized to a single group MESW or RMT condition. Established craving and withdrawal psychometric instruments were used as pre- and posttests to determine potential within- and between-group differences. Results: There were significant within-group differences in craving subscales of urges and coping as well as withdrawal, all p <.001. Within-group effect sizes ranged from.244 to.456 with favorable changes from pre- to posttest. There was no between-group difference among the MESW and RMT conditions, all p >.05. Conclusions: Although the specific music therapy intervention did not impact craving or withdrawal, a single MESW or RMT session can have an immediate and significant positive impact on craving and withdrawal in adults with SUD on a detoxification unit. As the MESW condition also addressed motivational and educational aspects of recovery, perhaps MESW interventions are ideal in detoxification settings.