Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 death annually and including all causes alcohol abuse accounts for around 90,000 deaths each year, making it the third leading preventable cause of death in the United States.
Obviously there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses.
In today’s Research News article “Relative Efficacy of Mindfulness-Based Relapse Prevention, Standard Relapse Prevention, and Treatment as Usual for Substance Use Disorders: A Randomized Clinical Trial”
Bowen and colleagues examine the ability of a 12-step program, a Relapse Prevention (RP) program, and Mindfulness-Based Relapse Prevention (MBRP) in preventing relapse over a one-year period.
The Relapse Prevention (RP) program attempts to prevent relapse by helping the abuser to identify situations that tend to precipitate relapse and teach cognitive (thinking) and behavioral skills to navigate through these situations. Mindfulness-Based Relapse Prevention (MBRP) employs some components of relapse prevention and adds mindfulness based components to increase awareness and behavioral flexibility in daily life.
They found at three month follow-up that all three programs were effective in preventing relapse. But at 6 months both the RP and MBRP programs were superior to the 12-step program in preventing relapse. The participants in these programs had significantly higher abstinence from drug use and refraining from heavy drinking. The superiority of the Mindfulness-Based Relapse Prevention (MBRP) program was evidenced at the one-year follow-up, reporting 31% fewer drug use days and a significantly higher probability of refraining from heavy drinking. So, all programs were effective over the short term, but over the long-term the mindfulness based program worked the best.
How can mindfulness help an addict to refrain from indulging over the long-term? Mindfulness training stresses present moment awareness of both internal and external stimuli. It puts the individual in better touch with their own feeling and thoughts in real time. The cognitive therapy components of the program help the individual properly interpret what their feeling and to change the way they think about themselves and others. This improves the addict’s ability to recognize and tolerate the discomfort associated with craving, interpret it correctly, not see it as a personal failure, and effectively employ an alternative technique to deal with craving.
In addition mindfulness is known to improve emotion regulation. The individual becomes better at recognizing and responding effectively to their own emotions. Thus the addict can better recognize emotions, particularly negative ones, and feel them thoroughly but respond to not with drugs or alcohol, but with responses more appropriate for the current situation.
Regardless of the mechanism the fact that mindfulness training can extend the effectiveness of relapse prevention is very significant. The longer the addict remains drug or alcohol free, the greater the likelihood of developing more adaptive behaviors which can, in turn, spawn the kind of success experiences that can help to maintain the drug free existence.
So, practice mindfulness and kick the habit.
CMCS – Center for Mindfulness and Contemplative Studies