Improve Substance Abuse Disorders with Mindfulness-Based Treatments
By John M. de Castro, Ph.D.
“incorporating mindfulness exercises into treatment is especially helpful for those of us who have struggled with addiction to alcohol, drugs, porn, unhealthy relationships, or other destructive behaviors.” – Beverly Conyers
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. 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 treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. The evidence has been accumulating so it makes sense to step back and summarize what has been learned in the most recent studies.
In today’s Research News article “Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392831/) Korecki and colleagues review and summarize the recently (2016-2020) published randomized controlled trials on the effectiveness of manualized mindfulness programs in treating substance abuse and preventing relapse. They identified 30 published randomized controlled trials employing mindfulness-based treatments that used structured protocols; were manualized.
They report that the published studies utilized a wide variety of mindfulness-based treatment protocols including Mindfulness-Based Relapse Prevention (MBRP), Mindfulness Oriented Recovery Enhancement (MORE), Mindfulness Training for Smokers (MTS), Moment-by-Moment in Women’s Recovery (MMWR), Mindfulness-Based Addiction Treatment (MBAT), and Mindful Awareness in Body-Oriented Therapy (MABT). These protocols have varied targeted components to address different addictions or different populations of addicts. But they have the common property of training in present moment awareness (mindfulness).
They report that the studies demonstrated that these Mindfulness-Based treatments were as effective and sometimes more effective than other existing evidenced-based treatments in treating substance use disorders. They report that these treatments significantly reduced the frequency of drug or alcohol use, the amounts of drugs or alcohol used, problems related to substance abuse, and cravings for the drugs or alcohol. In addition, they increased the rate of abstinence in the substance abuse patients.
This review of the most recent studies suggests that the use of mindfulness-based treatments for the treatment of substance abuse disorder are safe and effective on a level with or superior to other existing treatments. Future research should investigate the cost-effectiveness of the various treatments and which protocols work best for which forms of addictions and which types of addicts.
So, improve substance abuse disorders with mindfulness-based treatments.
“So much of the internal narrative around cravings is not being able to handle it. What you get from mindfulness is the realization that you can deal with this, you can tolerate this.” – Nicholas Barr
CMCS – Center for Mindfulness and Contemplative Studies
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Korecki, J. R., Schwebel, F. J., Votaw, V. R., & Witkiewitz, K. (2020). Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Substance abuse treatment, prevention, and policy, 15(1), 51. https://doi.org/10.1186/s13011-020-00293-3
Substance use disorders are prevalent and returning to substance use (i.e., relapse) following treatment is common, underscoring the need for effective treatments that will help individuals maintain long-term reductions in substance use. Mindfulness-based interventions (MBIs) have been increasingly developed and evaluated for the treatment of substance use disorders. The aim of this article was to update a systematic review conducted by Li et al. in 2017 on the outcomes of randomized control trials of MBIs for substance use disorders. In addition, we provided a session-by-session examination of the most widely used MBI protocols.
We conducted a comprehensive literature search of the PubMed, PsycINFO, and Web of Science databases from January of 2016 through April of 2020. Studies were included based on the following criteria: 1) examined the effects of an MBI, 2) employed a randomized controlled trial design with repeated measures, including secondary data analyses of randomized controlled trials, and 3) enrolled participants seeking treatment for substance use disorders.
The search identified 902 publications and 30 studies were eligible for inclusion and data extraction. MBIs appear to be as effective as existing evidence-based treatments for substance use disorders at reducing the frequency and quantity of alcohol and drug use, substance-related problems, craving for substance use, and at increasing the rate of abstinence.
Future directions include additional large scale randomized controlled trials, investigation of the most suitable settings and protocols, examination of patient populations that may benefit most from MBIs, and dissemination and implementation research.