A new pilot randomised controlled trial from Monash University has found promising early signs that approach bias modification (ApBM) may help reduce relapse risk for people undergoing residential treatment for methamphetamine use disorder (MUD).

Led by Professor Victoria Manning and published in Drug and Alcohol Review, the study found higher abstinence rates among active compared to sham-trained participants and good acceptance among those who completed all four sessions.

“More than half of ApBM participants reported past‑month abstinence at follow‑up, mirroring the 54% abstinence rate observed in the team’s previous 3‑month study,” Professor Manning says.

This consistency suggests ApBM may provide meaningful support during the early months after discharge.

“If larger, fully powered trials confirm differences in abstinence rates, ApBM could have important clinical applications,” Prof Manning says.

Clinical implications

ApBM is a neurocognitive training method that aims to reduce “approach bias”, the automatic tendency to move toward substance‑related cues.

“It has already shown strong results for people experiencing alcohol dependence, with several trials demonstrating reduced relapse rates for up to one year after discharge,” she says.

Since MUD accounts for 40% of residential rehabilitation treatment episodes in Australia, and fewer than one in four people remain abstinent for a year after treatment, ApBM could become a vital add-on support tool to help reduce the relapse rates among this group.

“The first three months after leaving residential treatment are a particularly vulnerable time, as people return to environments where substance cues are present, whilst they are still stabilising physically, cognitively and psychologically. Interventions such as ours that can delay or prevent relapse during this critical window may help strengthen longer‑term recovery,” Prof Manning says.

Cause for caution

Despite encouraging results, the study identified feasibility and safety concerns: 38% of participants did not complete all four sessions; many reported increased cravings after ApBM; and 9% withdrew because they found the training stimuli (such as images of methamphetamine and drug use paraphernalia) “triggering” or distressing.

“Methamphetamine’s strong impact on the brain’s dopamine system may make people who use it more sensitive to drug‑related cues, increasing the likelihood of triggering responses during ApBM,” Professor Manning explains.

Next steps

“Our research has shown that providing ApBM during short-stay residential rehabilitation may help reduce relapse risk after discharge. However, larger studies are needed to refine the intervention, improve safety, and determine how well it works for people being treated for MUD in longer-term residential rehabilitation settings,” Professor Manning says.

Read the paper: Approach With Caution: A Pilot Randomised Controlled Trial of Approach Bias Modification for People Undergoing Residential Treatment for Methamphetamine Use Disorder

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