Music Therapy as Adjunct in Community SUD Care: Pilot Insights

Immediate Craving Reduction Observed After Music Therapy Sessions

A 2026 pilot study registered on ClinicalTrials.gov (NCT number not disclosed) reports that music therapy (MT), when used alongside standard treatment (ST) for substance use disorder (SUD) in a community-based setting, is associated with immediate reductions in self-reported craving. Sixteen participants received either six weekly MT sessions plus ST or ST alone, with craving assessed using the Craving Thermometer immediately before and after each session. The study found that participants in the MT group consistently reported lower craving levels immediately following MT sessions, suggesting a potential acute benefit in craving management within the session window.

No Significant Post-Intervention Differences in Primary Outcomes

Despite the immediate effects, the study found no statistically significant differences between the MT+ST and ST-alone groups in primary craving outcomes (measured by the Brief Substance Craving Scale) or in resting-state beta power z-scores on electroencephalography (EEG) after the intervention period. While the MT group showed a descriptively larger reduction in beta power, the difference did not reach significance, likely reflecting the small sample size and pilot nature of the trial. This finding underscores the challenge of translating session-level effects into sustained clinical change, a critical consideration for future intervention design.

Neural and Qualitative Signals Inform Future Research Directions

The pilot identified significant differences in post-intervention frontal alpha asymmetry (an EEG marker linked to affective-motivational processing) after baseline adjustment, suggesting that MT may influence emotional processing domains relevant to SUD recovery. Additionally, the MT group exhibited a nominal, non-significant increase in P3d amplitude during a Go/NoGo task—a potential signal of enhanced response inhibition, although this did not reach statistical significance. Qualitative interviews provided further context, revealing themes of craving relief, emotional reflection, reluctance to discuss craving, and strengthened therapeutic connection. Notably, participants described music therapy as facilitating emotional engagement and self-reflection, which may underpin some of the observed neural changes.

• Concrete insight: The integration of EEG and qualitative data in this pilot highlights the value of multi-modal assessment in adjunctive SUD interventions, revealing candidate neural and experiential markers that could be missed by psychometric measures alone.

Policy and Research Implications: Need for Larger, Rigorous Trials

The findings suggest that while music therapy may offer immediate subjective relief from craving, its broader clinical utility remains unproven without evidence of sustained benefit. The lack of significant group differences post-intervention and the small sample size limit the generalizability of results. For policy makers and program designers, this study supports the cautious integration of music therapy as an adjunct rather than a replacement for evidence-based SUD treatments. Importantly, the use of neural and qualitative measures provides a template for future trials seeking to capture both mechanistic and experiential outcomes.

Future research should prioritize larger sample sizes, robust randomization, clearer comparators, and longer-term follow-up to determine whether the acute effects of music therapy can translate into durable clinical improvements. The study also suggests that affective-motivational and inhibitory control domains, as indexed by EEG, may be promising targets for mechanistic investigation in adjunctive SUD interventions.

Risks, Limitations, and Unknowns

This pilot study is limited by its small sample size, short duration, and lack of long-term follow-up, which restricts the ability to detect clinically meaningful effects and generalize findings. The absence of significant post-intervention differences in primary outcomes raises questions about the durability of music therapy's benefits. Additionally, the open-label design and reliance on self-reported measures introduce potential biases. There is also a risk that session-level improvements in craving may not translate into reduced substance use or relapse prevention, highlighting the importance of comprehensive outcome assessment in future trials.

Looking Forward: Integrating Multi-Modal Assessment in SUD Care

The 2026 pilot study underscores the potential value of combining neural, psychometric, and qualitative measures to assess adjunctive interventions like music therapy in SUD treatment. While immediate craving relief is promising, the lack of sustained benefit and the small scale of the study point to the need for more rigorous research before music therapy can be recommended for widespread adoption in community SUD care. For now, music therapy may serve as a supportive adjunct, particularly for patients seeking non-pharmacological options, but should not replace established treatments. The integration of multi-modal assessment in future trials will be critical to understanding both the mechanisms and the lived experience of adjunctive interventions in SUD recovery.

Reviewed by Dr. Alex Chen, MD, PhD (Addiction Psychiatry). How we research: All findings are based on first-party primary sources, including the original OpenAlex publication and trial registry. Reviewed for accuracy and neutrality on 2026-09-05.