By John M. de Castro, Ph.D.
“it’s tempting to conclude that mindfulness is the “best new thing” for addiction treatment, but that in reality, further study is needed. It absolutely has promise, we have a lot more to learn, this is the beginning.” – Sarah Bowen
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 deaths 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.
Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015
An important treatment component that may contribute to the effectiveness of MBRP is that it be practiced at home. The program recommends that meditation be practiced for 45 minutes a day. Yet, there has been no systematic research concerning compliance with home practice and its effects on the efficacy of treatment. In today’s Research News article “Enactment of Home Practice Following Mindfulness-based Relapse Prevention and its Association with Substance-use Outcomes”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260625/
Grow and colleagues recruited adults with substance abuse disorders who had successfully completed withdrawal and a therapeutic program randomly and were in remission. “Primary substances of abuse were alcohol (45.2%), cocaine/crack (36.2%), methamphetamines (13.7%), opiates/heroin (7.1%), marijuana (5.4%), and other (1.9%).” They were assigned to either a Mindfulness-based Relapse Prevention (MBRP) program or a standard aftercare program. The MBRP program consisted of 8 weekly 2-hour closed small group (6-11) sessions.
They found that MBRP participants engaged in home practice that peaked immediately after treatment and declined slightly 2 to 4-months post-treatment. Importantly the amount of home practice was significantly inversely related to cravings for drugs and the frequency of drug use post-treatment. In other words, the more the participant practiced at home the less they craved drugs and the less they used them. This underscores the potential importance of home practice.
It is important to note that the results do not demonstrate that engagement in home practice caused less craving and drug use as these results were correlative. It is possible that less craving and less drug use caused more home practice or that some third factor such as the degree of addiction was responsible for both. Regardless the present results indicate that there needs for closer study of what transpires outside of the treatment sessions as potential influences on the success of treatment.
So, improve drug and alcohol relapse prevention with mindfulness.
“If there is no opportunity to use then there is no internal struggle. It is this internal struggle that feeds the cravings. Trying to fight cravings is like trying to block a waterfall. We end up being inundated. With the approach of mindfulness, we step aside and watch the water (cravings, impulses & urges) just go right past.” – Chris Walsh
CMCS – Center for Mindfulness and Contemplative Studies