For a study, researchers sought to determine if four forms of drug cue and desire indicators, cue exposure, physiological cue reactivity, cue-induced seeking, and self-reported craving (without cue exposure), are linked with drug use and relapse in the future.

Google Scholar was used to look for published research from its beginning until December 31, 2018. In addition, backward and forward searches on included articles were undertaken to locate more articles. In humans, included research reported a prospective statistic linking cue and desire indicators at time 1 to drug use or relapse at time 2. The criteria for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were followed. One of the two writers retrieved and/or coded study features and statistics, which were then validated by the other. From May through July 2021, statistical analyses were carried out. Prospective odds ratios (ORs) indicating the relationship between cue and desire indicators and eventual drug use/relapse were calculated using random-effects models.

A total of 18,205 records were found, with 237 studies included. A significant prospective association of all cue and craving indicators with drug use/relapse was found across 656 statistics representing 51,788 human participants (21,216 with confirmed substance use disorders (SUDs)) (OR, 2.05; 95% CI, 1.94-2.15), such that a 1-unit increase in cue and craving indicators was associated with more than double the odds of future drug use or relapse. A Rosenthal fail-safe analysis found that 180,092 null studies would be needed to overturn this conclusion. Trim-and-fill analysis resulted in an adjusted effect size of 1.31 (95% CI, 1.25-1.38). Moderator analyses revealed that cue-induced desire, genuine cues or visuals, drug use results, same-day time lag, studies utilizing momentary ecological assessment, and male participants had some of the highest relationships.

According to the systematic review and meta-analysis findings, drug cue and desire indicators play key roles in drug use and relapse outcomes and are a crucial mechanism underpinning SUDs. Clinically, the findings supported including desire evaluation across all stages of therapy, beginning with basic care.