Retraining of drug reward, music cues and state-dependent recall in music therapy




Brain research revealed that pleasant music appreciation is processed in same brain reward areas as euphoriant drugs. This indicates a similarity in processing intensity of emotions in the brain. These insights shed a new light on how music and emotion are linked in the brain. However, patients, with a history of drug-induced euphoria, may experience a state-dependent recall induced from certain individually perceived cues, which have been experienced together with drugs, as memory traces are stored as conditioned secondary rewards in drug memory. Music’s state-dependent cognition processes seem to be recalled (and thereby also the drug action) when listening to music without being under the influence. These learning processes have to be focused and transformed in therapy by offering new ways of learning to recognize, retrain and integrate state-specific emotional responses to preferred music to rebalance emotion and experiencing reward.

Author Biography

Jörg Fachner, Anglia Ruskin University Department of Music and Performing Arts East Road, Cambridge CB1 1PT, UK

Prof. Jörg Fachner, DMSc, MS Ed.
Professor of Music, Health and the Brain


Whiteley S. The space between the notes - Rock and the counter culture. London: Routledge; 1992.

Markert J. Sing a song of drug use-abuse: Four decades of drug lyrics in popular music - From the sixties through the nineties. Sociological Inquiry 2001; 71(2): 194-220.

Manning P. Drugs and Popular Culture – Drugs, media and identity in contempory society. Cullompton: Willan Publishing 2007.

Szasz TS. Ceremonial chemistry : the ritual persecution of drugs, addicts, and pushers. Rev. ed. Syracuse, N.Y.: Syracuse University Press; 2003.

Sullivan RJ, Hagen EH. Psychotropic substance-seeking: evolutionary pathology or adaptation? Addiction 2002; 97(4): 389-400.

Sullivan RJ, Hagen EH, Hammerstein P. Revealing the paradox of drug reward in human Proceeding of the Royal Society B - Biological Sciences 2008; 2008 275 1231-41; .

Blätter AE, Fachner JC, Winkelman M. Addiction – Dynamics and Relations to Altered States of Consciousness. In: Cardenas E, Winkelman M, eds. Altering Consciousness: A multidisciplinary perspective. Santa Barbara: Praeger; 2011: 167-87.

Moore P. Enhancing me : the hope and the hype of human enhancement. Chichester, England ; Hoboken, NJ: Wiley/Dana Centre; 2008.

Nencini P. The shaman and the rave party: social pharmacology of ecstasy. Subst Use Misuse 2002; 37(8-10): 923-39.

Gerhard H. Party-drugs: sociocultural and individual background and risks. International Journal of Clinical Pharmacology and Therapeutics 2001; 39(8): 362-6.

Gahlinger PM. Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine. American family physician 2004; 69(11): 2619-26.

Battisti MC, Noto AR, Nappo S, Carlini Ede A. A profile of Ecstasy (MDMA) use in Sao Paulo, Brazil: an ethnographic study. J Psychoactive Drugs 2006; 38(1): 13-8.

Lönnqvist J. Stressi ja depressio (Stress and depression). 2009. (accessed January 19 2009).

Norris C. The medicated me. 2011 2011. (accessed 17th October 2013).

Baudelaire C. Les paradis artificiels: opium et haschisch. Paris: Poulet-Malassis et de Broise; 1860.

Boyd J. Musicians in tune - Seventy-five contempory musicians discuss the creative process. 1 ed. New York: Fireside, a Simon & Schuster imprimateur; 1992.

Shapiro H. Waiting For The Man - The Story of Drugs and Popular Music. 2 ed. London: Helter Skelter Publishing; 2003.

Fachner J. Music and drug induced altered states. In: Aldridge D, Fachner J, eds. Music and Altered States - Consciousness, Transcendence, Therapy and Addictions. London: Jessica Kingsley; 2006: 82-96.

Van Havere T, Vanderplasschen W, Lammertyn J, Broekaert E, Bellis M. Drug use and nightlife: more than just dance music. Subst Abuse Treat Prev Policy 2011; 6: 18.

Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci U S A 2001; 98(20): 11818-23.

Menon V, Levitin DJ. The rewards of music listening: Response and physiological connectivity of the mesolimbic system. Neuroimage 2005; 28(1): 175-84.

Salimpoor VN, Benovoy M, Larcher K, Dagher A, Zatorre RJ. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nat Neurosci 2011; 14: 257-62.

Yacubian J, Büchel C. The genetic basis of individual differences in reward processing and the link to addictive behavior. In: Dreher J-C, Tremblay L, eds. Handbook of Reward and Decision Making. 1 ed. Burlington: Academic Press; 2009: 345-60.

Carlson E, Saarikallio S, Toiviainen P, Bogert B, Kliuchko M, Brattico E. Maladaptive and adaptive emotion regulation through music: a behavioral and neuroimaging study of males and females. Front Hum Neurosci 2015; 9: 466.

Koelsch S. Music-evoked emotions: principles, brain correlates, and implications for therapy. Ann N Y Acad Sci 2015; 1337: 193-201.

Koob GF. Dynamics of Neuronal Circuits in Addiction: Reward, Antireward, and Emotional Memory. Pharmacopsychiatry 2009; 42(S 01): S32-S41.

Emrich HM, Schneider U. Facetten der Sucht. Von der Neurobiologie zur Anthropologie Frankfurt a.M: Peter Lang; 2006.

Small DM, Zatorre RJ, Dagher A, Evans AC, Jones-Gotman M. Changes in brain activity related to eating chocolate: from pleasure to aversion. Brain 2001; 124(Pt 9): 1720-33.

Spintge R. Die therapeutisch-funktionalen Wirkungen von Musik aus medizinischer und neurphysiologischer Sicht - Musik als therapeutische Droge. In: Rösing H, ed. Musik als Droge? Zu Theorie und Praxis bewußtseinsverändernder Wirkungen von Musik. Mainz: Villa Musica; 1991: 13-22.

Spintge R. Clinical Use of Music in Operating Theaters. In: MacDonald R, Kreutz G, Mitchell L, eds. Music, Health, and Wellbeing. Oxford - New York: Oxford University Press; 2012: 277 - 86.

Harikumar R, Raj M, Paul A, et al. Listening to music decreases need for sedative medication during colonoscopy: a randomized, controlled trail. Indian Journal of Gastroenterology 2006; 25(1): 3.

Bringman H, Giesecke K, Thörne A, Bringman S. Relaxing music as pre-medication before surgery: a randomised controlled trial. Acta Anaesthesiologica Scandinavica 2009; 53(6): 759-64.

Reuter J, Raedler T, Rose M, Hand I, Glascher J, Buchel C. Pathological gambling is linked to reduced activation of the mesolimbic reward system. Nat Neurosci 2005; 8(2): 147-8.

Erkkilä J, Eerola T. Gambling addiction: Evaluation of a multimethod treatment programme including music therapy In: Aldridge D, Fachner J, eds. Music Therapy and Addictions London and Philadelphia: Jessica Kingsley Publishers; 2010: 140-55.

Fachner J, Rittner S. Ethno therapy, music and trance - An QEEG investigation into a sound-trance induction. In: Cvetkovic D, Cosic I, eds. States of Consciousness: Experimental Insights into Meditation, Waking, Sleep and Dreams Berlin: Springer; 2011: 233-54.

Lee EJ, Bhattacharya J, Sohn C, Verres R. Monochord sounds and progressive muscle relaxation reduce anxiety and improve relaxation during chemotherapy: a pilot EEG study. Complementary Therapies in Medicine 2012; 20(6): 409-16.

Deshmukh AD, Sarvaiya AA, Seethalakshmi R, Nayak AS. Effect of Indian classical music on quality of sleep in depressed patients: A randomized controlled trial. Nordic Journal of Music Therapy 2009; 18(1): 70-8.

Winkelman M. Complementary therapy for addiction: "drumming out drugs". Am J Public Health 2003; 93(4): 647-51.

Metzner R. Addiction and transcendence as altered states of consciousness. Journal of Transpersonal Psychology 1994; 26(1): 1-17.

Julien RM, Advokat CD, Comaty JE. A primer of drug action : a comprehensive guide to the actions, uses, and side effects of psychoactive drugs. 11th ed. New York, NY: Worth Publishers; 2008.

Zarrindast M-R, Rezayof A. Morphine state-dependent learning: sensitization and interactions with dopamine receptors. European Journal of Pharmacology 2004; 497(2): 197-204.

Eich JE. State-dependent retrieval of information in human episodic memory. In: Birnbaum IM, Parker ES, eds. Alcohol and Human Memory (PLE: Memory): Psychology Press; 2014: 141-58.

Fachner J. Music therapy, drugs and state-dependent recall. In: Aldridge D, Fachner J, eds. Music therapy and addictions. 1 ed. London: Jessica Kingsley; 2010: 18-34.

Esch T, Stefano GB. The neurobiology of pleasure, reward processes, addiction and their health implications. Neuroendocrinology Letters 2004; 25(4): 235-51.

McClung CA, Ulery PG, Perrotti LI, Zachariou V, Berton O, Nestler EJ. DeltaFosB: a molecular switch for long-term adaptation in the brain. Brain Research 2004; 132(2): 146-54.

Nestler EJ. Molecular mechanisms of drug addiction. Neuropharmacology 2004; 47 Suppl 1: 24-32.

Shulz DE, Sosnik R, Ego V, Haidarliu S, Ahissar E. A neuronal analogue of state-dependent learning. Nature 2000; 403(6769): 549-53.

Fachner J. Drugs, altered states and musical consciousness: reframing time and space. In: Clarke E, Clarke D, eds. Music and consciousness. Oxford: Oxford University Press; 2011: 263-80.

Böhm T. Was ist Psychedelic Rock? Zum Einfluß von Drogen auf die Musik am Beispiel der Beatles und LSD. In: Rösing H, Phleps T, eds. Erkenntniszuwachs durch Analyse - Populäre Musik auf dem Prüfstand. 1 ed. Karben: Coda; 1999: 7-25.

Boening JA. Neurobiology of an addiction memory. Journal of Neural Transmission 2001; 108(6): 755-65.

Thaut MH, de l'Etoile SK. The effects of music on mood - state-dependent recall. Journal of Music Therapy 1993; 30(2): 70-80.

Globus GG, Cohen HB, Kramer JC, Elliot HW, Sharp R. Effects of marihuana induced altered state of consciousness on auditory perception. Journal of Psychedelic Drugs 1978; 10(1): 71-6.

Overton DA. Historical context of state dependent learning and discriminative drug effects. Behavioural Pharmacology 1991; 2(4-5): 253-64.

Gebhardt S, Kunkel M, von Georgi R. Music helps addicted patients to reduce negative emotions in everyday life. Rearch Journal of Drug Abuse, 2014.

Fritz TH. Benefits of listening to a recording of euphoric joint music making in polydrug abusers. Frontiers in Human Neuroscience 2015; 9.

Short ADL, Dingle GA. Music as an auditory cue for emotions and cravings in adults with substance use disorders. Psychology of Music 2015.

Eerola T, Peltola HR. Memorable Experiences with Sad Music-Reasons, Reactions and Mechanisms of Three Types of Experiences. PLoS One 2016; 11(6): e0157444.

Saarikallio S, Gold C, McFerran K. Development and validation of the Healthy-Unhealthy Music Scale. Child Adolesc Ment Health 2015; 20(4): 210-7.

McFerran KS. Contextualising the relationship between music, emotions and the well-being of young people: A critical interpretive synthesis. Musicae Scientiae 2016; 20(1): 103-21.

Loxton NJ, Mitchell R, Dingle GA, Sharman LS. How to tame your BAS: Reward sensitivity and music involvement. Personality and Individual Differences 2016; 97: 35-9.

Horesh T. Drug addicts and their music - A Story of a Complex Relationship. In: Aldridge D, Fachner J, eds. Music therapy and Addictions. London: JKP; 2010: 57-74.






Full Length Articles