Effectiveness of Transcranial Direct-Current Stimulation (tDCS) and Emotion Regulation Training in Reducing Current Drug Craving and Drug-Use Thoughts and Fantasies in Opioid-Dependent Patients: The Issue of Precedence

Craving is an important factor in predicting relapse in opioid-dependent patients. The aim of the present study was to determine which combination therapy, including emotion regulation training followed by tDCS or tDCS followed by emotion regulation training, is more effective in reducing current drug craving and drug-use thoughts and fantasies in opioid-dependent patients in Zahedan, Iran. A quasi-experimental study with a pretest-posttest design and two intervention groups was conducted. From eight randomly-selected centers, asample of 28 patients was selected based on the inclusion and exclusion criteria. They were randomly divided into two intervention groups. The first group received eight sessions of tDCS, followed by eight sessions of emotion regulation training. The second group received eight sessions of emotion regulation training followed by eight sessions of tDCS. The statistical population included all opioid-dependent patients at medium-term residential drug rehabilitation centers in Zahedan, Iran, in 2018 - 2019. The data were gathered using the personal drug use questionnaire, the desires for drug questionnaire (DDQ), and the drug use thoughts, fantasies, and temptations questionnaire. All analyses were performed using SPSS-16. The results of repeated measures ANOVA showed that both sequences had a significant, long-term effect on the reduction of current drug craving and drug-use thoughts and fantasies in opioid-dependent patients. In addition, emotion regulation training followed by tDCS was more effective in reducing current drug craving and drug-use thoughts and fantasies than tDCS followed by emotion regulation training. Combination therapy can significantly reduce drug craving in opioid-dependent patients and starting treatment with emotion regulation training followed by tDCS can lead to better results.