The Musical Reassociation Model (MRM): A Stage-Based Framework for Managing Music-Related Cues and Reclaiming Musical Agency in Substance Use Disorder Recovery.

Music plays a central role in identity, emotion regulation, and everyday functioning, yet in the context of substance use disorders, it may also become conditioned through repeated pairing with intoxication and later function as a cue for craving, urges to use, or emotional destabilization. Existing literature has recognized both the risks and therapeutic potential of music in recovery but has offered limited stage-sensitive guidance for clinical decision-making. This article introduces the Musical Reassociation Model (MRM), a stage-based conceptual framework that maps how the relationship between music and substance use evolves across addiction and recovery. The model describes five distinct phases: (1) the synergy phase, characterized by mutual enhancement between music and substance use; (2) acoustic erasure, marking the collapse or distortion of music's aesthetic and self-regulatory function; (3) stabilization through avoidance or substitution; (4) active tolerance through graded exposure, musical agency, and reassociation; and finally (5) integration, in which music is reclaimed as a recovery resource. Across these stages, the MRM reframes music not only as a trigger to be managed but as a dynamic domain of identity, self-regulation, and agency. The model highlights a key clinical distinction between short-term stabilization strategies based on environmental control and later-stage interventions aimed at building durable agency in the presence of problematic music cues. It also introduces the construct of Aesthetic Recovery Capital to describe the musical, social, and interpretive resources that support reintegration in the aesthetic domain. By integrating cue reactivity, identity reconstruction, recovery-oriented theory, and recovery capital, the MRM provides a theoretically grounded account of how music shifts from a substance-linked vulnerability to an integrated recovery resource. The article concludes by discussing clinical implications and illustrative vignettes, while outlining directions for future research, such as validating stage boundaries, examining digital listening environments, and developing stage-matched therapeutic interventions.