Addictive Behaviors, Vol. 15, pp. 335-337, 1990 Printed in the USA. All rights reserved. 0306-4603/90 $3.00 + .OO Copyright 0 1990 Pergamon Press plc GUEST EDITORIAL CUE EXPOSURE AS A PRACTICAL TREATMENT FOR ADDICTIVE DISORDERS: WHY ARE WE WAITING? NICK HEATHER University of New South Wales, Australia BRENDAN P. BRADLEY University of Cambridge, U.K. The five articles to which these remarks serve as an introduction are based on a symposium on “Cue Exposure in the Addictive Behaviors” presented at the Behavior Therapy World Congress in Edinburgh in September 1988. This symposium was one of two on the general topic of addictive behaviours included in the Congress program. It was well attended and feedback was positive. Our main reason for convening the symposium was that it appeared to us that there had been a curious delay in translating highly promising research findings, combined with an extensive theoretical base in conditioning theory, into usable treatment methods. As one of us has pointed out elsewhere (Heather & Greeley, in press), it is now over 40 years since Wikler (1948) first suggested that drug craving could be seen as a form of classically conditioned response and that such responses could play a significant role in relapse. During this time, exposure methods have been developed in other fields to a point where they are now the treatment of choice for anxiety and obsessive-compulsive disorders. Given that success story, we could surely have expected greater progress in applying exposure methods to the addictive disorders. More specifically, with the honorable exception of the work of the O’Brien group in Philadelphia, there have been no controlled trials conducted in the practical treatment situation, comparing cue exposure with other forms of intervention, in particular, with other methods of attempting to decrease the probability of relapse. So minimal has been the penetration of exposure methods into the range of treatments available for addictive disorders anywhere in the world that, in terms of treatment delivery, it is still legitimate to call cue exposure “a new method” for the prevention of relapse (cf. Heather & Greeley, in press). In an attempt to do something about this situation, we assembled some of the leading researchers across the range of addictive behaviors in Edinburgh and asked them to provide an up-to-date review of their work. There may be identifiable reasons for the delay. With regard to heroin and other illicit drugs, it may be part of the more general failure of behavioural methods to make much of an impact on the mainstream of treatment. Here, the work of O’Brien and his colleagues serves as a splendid example of how experimental, clinical and, more recently, treatment evaluation research may be integrated. In the present collection of papers, O’Brien, Childress, McLellan, and Ehrman (1990) give a brief account of their previous work on conditioning factors in drug dependence in general before describing in more detail the latest results from their laboratory on the treatment of cocaine dependence. It is also encouraging that to note that Gray and his colleagues in London are currently 335