Improve the Psychological Well-Being of Opioid Users Undergoing Medicinal Therapy with Mindfulness
By John M. de Castro, Ph.D.
“As individuals with [Substance Use Disorders] engage in mindfulness practices within [Mindfulness-Based Interventions], they learn to cultivate trait mindfulness, providing a bulwark against substance use and relapse.” – Sarah E Priddy
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 and preventing relapses. Medicinal therapies with drugs such as buprenorphine/naloxone have also been effective. But there is a need to study the effectiveness of mindfulness training in combination with medicinal therapy on relapse prevention.
In today’s Research News article “Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/ ) Zullig and colleagues recruited patients who were addicted to opioids and after treatment had been opioid free for at least 90 days. They continued on receiving treatment with daily injections of buprenorphine/naloxone and attending Narcotics Anonymous meetings. Patients who volunteered underwent additional 24 weeks of twice weekly 60-minute sessions of Mindfulness-Based Relapse Prevention (MBRP) treatment. The participants were measured before, at midpoint, and after treatment and 12 weeks later for relapse, craving symptoms, anxiety, depression, and mindfulness.
They found that 73% of the participants were retained through the entire 36 weeks with no differences between groups. Relapse occurred in 45% of the participants but there were no differences between groups. Cravings declined throughout the 36 weeks but again there were no differences between groups. On the other hand, the decline in anxiety and depression and increase in mindfulness was significantly greater for the group that received Mindfulness-Based Relapse Prevention (MBRP).
The findings suggest that adding Mindfulness-Based Relapse Prevention (MBRP) to medicinal therapy for opioid relapse prevention produced significantly lower levels of anxiety and depression in the patients. But it did not appear to improve relapses or cravings. More research is needed to ascertain whether the additional cost and staff support involved in implementing MBRP is justified by the additional improvements in psychological well-being.
So, improve the psychological well-being of opioid users undergoing medicinal therapy with mindfulness.
“Mindfulness-Based Relapse Prevention (MBRP) has been shown to help with physical and psychological well-being, reduce craving, and help with anxiety and depression.” – Keith Zullig
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are available on Twitter @MindfulResearch
Study Summary
Zullig, K. J., Lander, L. R., Tuscano, M., Garland, M., Hobbs, G. R., & Faulkenberry, L. (2021). Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-021-01763-w
Abstract
Objectives
This study aimed to explore the effectiveness of mindfulness-based relapse prevention (MBRP) with individuals receiving medication for opioid use disorder (MOUD) in a naturalistic, open-ended outpatient group treatment setting.
Methods
Eighty participants (mean age 36.3) who had at least 90 consecutive days substance free self-selected into treatment (MBRP, n = 35) or comparison groups (treatment as usual, TAU, n = 45). Outcomes tracked included treatment retention and relapse, and self-reported craving, anxiety, depression, and mindfulness at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. MBRP group participants attended biweekly 60-min sessions for 24 weeks. A linear mixed model analysis of variance determined the significance of the MBRP intervention on changes in craving, anxiety, depression, and mindfulness.
Results
No significant differences in sex, education level, insurance status, relationship status, or employment status were detected at baseline between groups. The 36-week retention (74%, MBRP/MOUD; 71%, TAU/MOUD) and relapse rates (43%, MBRP/MOUD; 47%, TAU/MOUD) were similar for the groups. There were only four relapses on opioids. Significant reductions (p < .05) were observed in the MBRP/MOUD group for craving, anxiety, and depression in addition to significant increases in mindfulness compared to those in TAU/MOUD.
Conclusions
Although state and federal resources are available to expand MOUD, no standard of behavioral therapy has been established as most complimentary to MOUD. The current study results suggest MBRP can be implemented as an outpatient therapy for individuals in MOUD.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/