Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: a meta-analysis of addiction-related and emotional symptoms.

Objective: This meta-analysis identified the effects of EMDR on both addiction-related symptoms (e.g., craving, addiction severity) and comorbid emotional symptoms (e.g., posttraumatic stress disorder (PTSD), depression, anxiety), and the influence of moderator variables across these symptom domains in substance use disorders (SUDs). Methods: We systematically searched the literature published up to June 2025 through major databases including Cochrane, PubMed, Embase, and PsycINFO. A total of 14 studies were included in the final analysis, including randomized controlled trials (RCTs), randomized crossover studies, and quasi-experimental studies. The effect size was calculated using Hedges' g based on pre-to-post treatment changes, and a meta-analysis was conducted using a random-effects model. In addition, meta-regression and subgroup analyses were performed, focusing on moderator variables such as study design, intervention type, total session number, and participant characteristics. Results: The meta-analysis results showed that EMDR produced a significant treatment effect with moderate or higher effect sizes for craving (g = 0.55), PTSD (g = 0.69), depression (g = 0.64), and anxiety (g = 0.72) symptoms, and heterogeneity ranged from low to moderate. On the other hand, the effect on addiction severity was not significant (g = 0.14). The effect on craving showed significant differences depending on the diagnostic group of the participants (Alcohol/Drug Use Group vs. Nicotine Use Group) and the study design (RCT vs. non-RCT). Some studies observed a short-term effect of reducing craving, but the evidence supporting long-term treatment effects was limited. Conclusion: These findings suggest that EMDR may be an effective intervention not only for emotional comorbid symptoms in individuals with SUD, but also for certain addiction-related symptoms, particularly in reducing craving. However, the quality of the included studies was generally low, and there was a lack of evidence regarding long-term effects. Future studies should employ more rigorous research designs, include sufficient sample sizes and long-term follow-up assessments, and perform detailed analyses that take into account intervention types and participant characteristics. Such research will help to clarify the therapeutic utility of EMDR and promote its practical application in addiction treatment settings. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251070837, identifier CRD420251070837.