Slightly Improve Substance Use Disorder with Mindfulness

Slightly Improve Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“though it may seem paradoxical, by increasing your ability to accept and tolerate the present moment, you become more able to make needed changes in your life. . . Also, practicing balanced emotional responses can reduce your stress level, and anxiety and stress are often triggers for substance abuse and addictive behavior. In addition, when you choose a neutral rather than a judgmental response to your thoughts and feelings, you can increase your sense of self-compassion rather than beating yourself up, which is often associated with addictive behaviors.” – Adi Jaffe

 

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. 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

 

In today’s Research News article “Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636047/, Grant and colleagues review and perform a meta-analysis of the published research literature on the effectiveness of Mindfulness-based Relapse Prevention (MBRP) in treating substance use disorder. They identified 9 randomized controlled trials and examined the effects of MBRP on relapse, frequency and quantity of substance use, withdrawal/craving symptoms, treatment dropout, depressive and anxiety symptoms, negative consequences from substance use, and health-related quality of life and also its safety

 

They found that the summarized published research literature reported few and small positive effects. On most of the outcome measures there were no significant improvements produced by MBRP. Small significant improvements were found for withdrawal effects and cravings and the negative effects of substance use. They found that there were no adverse effects of MBRP. These are disappointing results that suggest that Mindfulness-based Relapse Prevention (MBRP) is safe but only slightly effective in treating substance use disorder.

 

These are surprising results as individual trials have reported significant effects. But, it appears that the different trials reported significant effects on different variables with some finding effects on a measure while others finding no effects on the same measure but reporting effects on different measures. When summarized, the reported effects appear to average away. Substance use disorder is such an important social and health issue where there are few viable treatment options, that further research on Mindfulness-based Relapse Prevention (MBRP) is warranted to investigate what components are effective and which not and how to optimize effectiveness.

 

So, slightly improve substance use disorder with mindfulness.

 

“Modeled after mindfulness-based cognitive therapy for depression and mindfulness-based stress reduction, MBRP tackles the very roots of addictive behavior by targeting two of the main predictors of relapse: negative emotions and cravings.” – Carolyn Gregoire

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sean Grant, Benjamin Colaiaco, Aneesa Motala, Roberta Shanman, Marika Booth, Melony Sorbero, Susanne Hempel. Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis. J Addict Med. 2017 Sep; 11(5): 386–396. Published online 2017 Jul 19. doi: 10.1097/ADM.0000000000000338

 

Abstract

Objectives:

Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs.

Methods:

We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results:

We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46–1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI −0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD −0.09, 95% CI −0.39 to 0.21, low QoE), anxiety symptoms (SMD −0.32, 95% CI −1.16 to 0.52, very low QoE), and mindfulness (SMD −0.28, 95% CI −0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD −0.13, 95% CI −0.19 to −0.08, I2 = 0%, low QoE) and negative consequences of substance use (SMD −0.23, 95% CI −0.39 to −0.07, I2 = 0%, low QoE). We found negligible evidence of adverse events.

Conclusions:

We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636047/

Reduce Drug Addiction and Prison Recidivism with Mindfulness

Reduce Drug Addiction and Prison Recidivism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being in prison presents tremendous obstacles to cultivating a peaceful mind, the environment is conducive to negativity and can result in further harm. On every level, the basic antidote to inner and outer obstacles is mindfulness practice.” – Sakyong Mipham Rinpoche,

 

Around 2 ¼ million people are incarcerated in the United States. Many are serving time for drug related offenses. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

Prison provides a great deal of time for reflection and self-exploration. This provides an opportunity for growth and development. Contemplative practices are well suited to this environment. Meditation teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, meditation has been shown to be effective in treating depressionanxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

In addition, mindfulness can help to treat drug addictions that often underlie incarceration and promote recidivism after release. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Narcotics 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 not only produce abstinence but also prevent relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse. So, mindfulness training can be helpful in preventing recidivism.

 

In today’s Research News article “Prison Meditation Movements and Mass Incarceration.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633398/, Lyons and Cantrell review the published research literature on the effectiveness of mindfulness trainings on reducing drug addiction and prisoner recidivism. They report that the research supports the effectiveness of mindfulness in combating drug addiction and its effects may last longer than other forms of addiction therapy even in prison populations. Importantly, improvements have been shown to be maintained after release from prison. Additionally, meditation programs in prison have been shown to produce significant reductions in prisoner hostility and increases in self-esteem and mood.

 

Hence, meditation training can be effective in the treatment of addictions and the psychological issues of prisoners and can have effects that continue post-release. Lyons and Cantrell postulate that the presence of a meditation group (Sangha) in prison creates a social context that is very important for success. They also suggest that linking the prisoners to meditation groups outside of prison can be helpful in maintaining benefits after release. They also suggest that focusing on experiences in meditation and empowering prisoners to lead their own groups may be help to potentiate effectiveness. So, meditation training in prison appears to be a promising practice to assist prisoners in coping with addiction and improving their psychological state while in prison and continuing after release. This is likely to help prisoners adjust to the outside world and reduce the likelihood that they will be arrested again and returned to prison.

 

So, reduce drug addiction and prison recidivism with mindfulness.

 

How do we bring sanity into one of the most hostile environments of our society ­- our prisons? . . . Mindfulness creates mental discipline and stability. This provides the inmates with the tools they need to cultivate a sense of ease, decency and compassion. Isn’t that the point of rehabilitation?” – Elizabeth Mattis Namgyel

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lyons, T., & Cantrell, W. D. (2016). Prison Meditation Movements and Mass Incarceration. International Journal of Offender Therapy and Comparative Criminology, 60(12), 1363–1375. http://doi.org/10.1177/0306624X15583807

 

Abstract

By some estimates more than half of inmates held in jails and prisons in the United States have a substance use disorder. Treatments involving the teaching of meditation and other contemplative practices have been developed for a variety of physical and mental disorders including drug and alcohol addiction. At the same time, an expanding volunteer movement across the country has been bringing meditation and yoga into jails and prisons. This review first examines the experimental research on one such approach – mindfulness meditation as a treatment for drug and alcohol addiction, as well as the research on mindfulness in incarcerated settings. We argue that in order to make a substantial impact on recidivism, such programs must mirror volunteer programs which emphasize interdependency and non-duality between the “helper” and the “helped,” and the building of meditation communities both inside and outside of prison.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633398/

Reduce Compulsive Sexual Behavior with Mindfulness

Reduce Compulsive Sexual Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

ve Sexual Behavior with Mindfulnessfeeling ashamed of one’s sexual desires, interests, fetishes, and so on, only makes one feel more obsessive and compulsive about them, rather than the opposite. . .. Mindfulness practice helps my clients to observe their reactions to themselves in accepting and non-judgmental ways. Also, they learn to catch and become aware of the negative thoughts and emotions that arise that make them feel compelled to act out.” – Michael Aaron

 

Sexual behavior is a very important aspect of human behavior, especially for reproduction. In fact, Sigmund Freud made it a centerpiece of his psychodynamic theory. At its best, it is the glue that holds families and relationships together. But, it is a common source of dysfunction and psychosocial problems. Compulsive sexual behavior “encompasses problems with preoccupation with thoughts surrounding sexual behavior, loss of control over sexual behavior, disturbances in relationships due to sexual behavior, and disturbances in affect (e.g., shame) due to sexual behavior.” It is also called sex addiction and hypersexuality. It is chronic and remarkably common affecting 3% to 17% of the population. In addition, it is associated with substance abuse in around half of people with compulsive sexual behavior.

 

Compulsive sexual behavior is frequently treated with psychotherapy, Cognitive Behavioral, Therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. As a first step in evaluation this possibility, the relationship between mindfulness and compulsive sexual behavior needs to be investigated in these individuals.

 

In today’s Research News article “The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/, Shorey and colleagues recruited men in a residential treatment center for substance abuse. Upon admission to the facility and after withdrawal from drugs the men completed a battery of tests including measures of mindfulness, alcohol use, drug use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect (emotional) disturbance.

 

They found that the higher the level of mindfulness that the men had the lower the levels of drug use, alcohol use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect disturbance. These relationships with compulsive sexual behavior remained significant and negative even when drug and alcohol use were factored in. In contrast, drug use was not related to compulsive sexual behavior, except for a positive relationship with relationship disturbance. So, although there’s high comorbidity between substance abuse and compulsive sexual behavior, they don’t appear to be highly related.

 

These are encouraging results that suggest that mindfulness may be an antidote for compulsive sexual behavior in patients with substance abuse. These results, however, are correlative and so causation cannot be concluded and are only applicable to men. The next step, of course, will be to form a randomized clinical trial of the effects of mindfulness training on compulsive sexual behavior in patients with substance abuse in both men and women to establish the efficacy of mindfulness training as a treatment. It is possible that mindfulness training will be effective for the treatment of both substance abuse and compulsive sexual behavior in both genders.

 

So, reduce compulsive sexual behavior with mindfulness.

 

“findings tentatively support the usefulness of mindfulness in the effective treatment of sex addiction. In addition to helping bring about a reduction in dysfunctional sex-related actions, fantasies and thoughts, mindfulness training may help affected individuals gain improved emotional control, an increased ability to handle stressful situations and improved resistance to any potentially damaging sex-related urges that arise.” – The Ranch

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders. Mindfulness, 7(4), 866–873. http://doi.org/10.1007/s12671-016-0525-9

 

Abstract

Substance use disorders (SUDs) are a serious worldwide problem. Despite years of research on the treatment of SUDs, relapse remains high. One factor that may complicate SUDs treatment for some patients is compulsive sexual behavior. Factors that are related to both SUDs and compulsive sexual behavior could be targeted in SUDs treatment. In the current study, we examined dispositional mindfulness, a protective factor for a range of mental health problems, and its relationship to compulsive sexual behavior in a SUDs treatment sample. This is the first study to examine this relationship in a SUDs sample. Medical records from men in residential SUDs treatment were reviewed for the current study (N = 271). Upon admission to treatment, men completed self-report measures on alcohol and drug use, dispositional mindfulness, and compulsive sexual behavior. Bivariate correlations demonstrated dispositional mindfulness to be negatively associated with a variety of indicators of compulsive sexual behavior. After controlling for alcohol and drug use and problems in hierarchical regression analyses, which were both associated with compulsive sexual behaviors, dispositional mindfulness remained negatively associated with all of the compulsive sexual behavior indicators. Our results provide the first empirical association between dispositional mindfulness and compulsive sexual behavior in a SUDs sample. Although continued research is needed in this area, our findings suggest that it may be beneficial for SUDs treatment to incorporate mindfulness-based interventions for individuals with comorbid compulsive sexual behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/

Reduce Addictions Relapse in Minority Women with Mindfulness

Reduce Addictions Relapse in Minority Women with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By being mindful the individual will be able to see that these cravings appear in the mind and then disappear. They are like clouds passing through the sky. Sometimes just acknowledging the craving will be enough to make it disappear.“ – Addiction Rehab

 

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  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 addictionsMindfulness-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

 

In today’s Research News article “Mindfulness-based relapse prevention with racial and ethnic minority women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441877/, Witkiewitz and colleagues recruited adult women in a residential substance abuse treatment facility for criminal offenders.   All of the women were abstinent at the time of treatment. Substance abuse included “methamphetamines (15%), alcohol (12%), heroin (11%), marijuana (10%), crack cocaine (9%), and hallucinogens (2%).” The women were randomly assigned to receive twice weekly 50-minute sessions over 8 weeks of either standard relapse prevention treatment or Mindfulness-based Relapse Prevention (MBRP). They were measured before treatment and 6 months later for drug use and addiction severity.

 

They compared the effectiveness of standard relapse prevention treatment to Mindfulness-based Relapse Prevention (MBRP) and compared minority women to non-hispanic white women. They found that (MBRP) produced significantly better relapse prevention for the minority women including less drug use and addiction severity. In fact, the minority women treated with (MBRP) had no drug use at all in the 6 months following treatment.

 

These are interesting results that (MBRP) is effective in preventing relapse but also that it is most effective for minority women. The improved addiction severity scores were due primarily to fewer health problems in the minority women. It is not known exactly why (MBRP) is more effective for minority women in producing improved abstinence and better general health. Nevertheless, the study does demonstrate that (MBRP) is an effective treatment preventing relapse after addiction recovery especially with minority women.

 

So, reduce addictions relapse in minority women with mindfulness.

 

“the classical Buddhist meditation literature and recent scientific findings appear to agree that when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioral addictions and for improving psychological health more generally.” – Mark Griffiths

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Witkiewitz, K., Greenfield, B. L., & Bowen, S. (2013). Mindfulness-based relapse prevention with racial and ethnic minority women. Addictive Behaviors, 38(12), 2821–2824. http://doi.org/10.1016/j.addbeh.2013.08.018

 

Highlights

  • Results from a trial of relapse prevention (RP) and mindfulness-based RP (MBRP)
  • MBRP was more efficacious than RP for racial or ethnic minority female clients.
  • At follow-up, minorities in MBRP had no drug use days and lower addiction severity.

Abstract

Racial and ethnic disparities in the treatment of addiction have been acknowledged for several years, yet little is known about which empirically supported treatments for substance use disorders are more or less effective in treating racial and ethnic minority clients. The current study was a secondary analysis of a randomized clinical trial of two evidence-based treatments, mindfulness-based relapse prevention (MBRP) and relapse prevention (RP), as part of a residential addiction treatment program for women referred by the criminal justice system (n = 70). At 15-week follow-up, regression analyses found that racial and ethnic minority women in MBRP, compared to non-Hispanic and racial and ethnic minority women in RP, reported significantly fewer drug use days (d = .31) and lower addiction severity (d = .65), based on the Addiction Severity Index. Although the small sample size is a limitation, the results suggest that MBRP may be more efficacious than traditional treatments for racial and ethnic minority women.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441877/

Stay Abstinent from Smoking Mindfully

Stay Abstinent from Smoking Mindfully

 

By John M. de Castro, Ph.D.

 

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/, Heppner and colleagues recruited African American smokers who smoked at least 5 cigarettes per day for at least one year and enrolled in a smoking cessation treatment program. They were measured 19 and 5 days before quitting smoking and 3 days, 31 days, and 26 weeks after quitting for cigarettes smoked per day, smoking abstinence, mindfulness, positive and negative emotions, dependence and withdrawal symptoms, self-efficacy, and social support.

 

They found that the number of participants remaining abstinent dropped precipitously over 26 weeks but mindfulness mattered. Abstinence dropped to around 7% of participants who were low in mindfulness but to only 14% of participants who were high in mindfulness. Of those participants who relapsed at day 3 after treatment high mindfulness participants were significantly more likely to recover abstinence by day 31 and week 26. They also found that the improvement in abstinence at day 3 produced by mindfulness occurred primarily as a result of mindfulness producing lower levels of sadness, anger, and depression, lower use of smoking to control emotions, and more social support which in turn were associated with better abstinence rates.

 

These results are interesting but correlational, so causation cannot be determined. But, prior research has shown that mindfulness training improves treatment for nicotine addiction. So, it is likely that the relationships between mindfulness and smoking cessation observed in the present study were due to mindfulness causing the improved abstinence. Mindfulness acted through intermediaries of improved emotion regulation and improved social support to support abstinence. These results suggest that mindfulness is very helpful in remaining abstinent after quitting smoking and should become a component of all smoking cessation treatment packages.

 

So, stay abstinent from smoking mindfully.

 

“each time the individual does not succumb to the craving, the craving becomes weaker until eventually it no longer gets triggered. Moreover, with each moment of mindfulness, the smoker regains a sense of control and understanding regarding their mind and body, which can be empowering.”Azadeh Aalai

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Heppner, W. L., Spears, C. A., Correa-Fernández, V., Castro, Y., Li, Y., Guo, B., … Wetter, D. W. (2016). Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 50(3), 337–347. http://doi.org/10.1007/s12160-015-9759-3

 

Abstract

Background

Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation.

Purpose

The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers.

Methods

Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3 days, 31 days, and 26 weeks post-quit.

Results

Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support.

Conclusions

Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/

Reduce Drinking Motives and Problematic Drinking with Mindfulness

Reduce Drinking Motives and Problematic Drinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It may not be possible for people to completely escape cravings, but they can learn to live with them. Mindfulness meditation is an excellent tool that allows the individual to have increased control over their mind. There is a saying that, the mind is a wonderful servant but a terrible master.” – Alcoholrehab.com

 

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

 

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

 

These are striking and alarming statistics and indicate that controlling alcohol intake is an important priority for the individual and society. There are a wide range of treatment programs for alcohol abuse, with varying success. Recently, mindfulness training has been successfully applied to treatment. One attractive feature of this training is that it appears to increase the ability of the drinker to control their intake, resulting in less binge drinking and dangerous inebriation. It appears that one way that mindfulness increases the control of intake is by reducing the desire to use alcohol to cope with emotional problems. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to better understand its mechanisms of action in order to maximize its effectiveness.

 

In today’s Research News article “Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/. Vinci and colleagues recruited college students and had them complete measures of problem drinking, drinking characteristics, including frequency, quantity, and binge drinking, drinking motives including coping, enhancement, social, and conformity, and mindfulness. They performed regression and structural modelling analyses on these data.

 

They found that the higher the level of the mindfulness facet of acting with awareness that the students had the lower the levels of problem drinking. In addition, the association of acting with awareness with lower problem drinking occurred through two routes, a direct effect of acting with awareness on problem drinking and indirect effects through lower levels of using drinking for coping with negative emotions and lower levels of drinking to conform to the social situation. Hence, mindfulness is directly associated with less problem drinking and with lower levels of susceptibility to use drinking to sooth negative feelings and to conform to the behaviors of others.

 

Since, problem drinking is such a major societal and individual problem that develops during adolescence, the fact that mindfulness may help to lower problem drinking in college students suggests that mindfulness training may be an important intervention during these formative years. It remains for future research to determine if  active mindfulness training in college students can lead to decreased problem drinking.

 

So, reduce drinking motives and problematic drinking with mindfulness.

 

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away. Awareness of our experience and the ability to relate to our experience with compassion gives us more freedom to choose how we respond to discomfort, rather than defaulting to automatic behaviors.” – Sarah Bowen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Vinci, C., Spears, C. A., Peltier, M. R., & Copeland, A. L. (2016). Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use. Mindfulness, 7(3), 754–763. http://doi.org/10.1007/s12671-016-0515-y

 

Abstract

Mindfulness is a multi-faceted construct, and research suggests that certain components (e.g., Acting with Awareness, Nonjudging) are associated with less problematic alcohol use. Recent research has examined whether specific drinking motives mediate the relationship between facets of mindfulness and alcohol use. The current study sought to extend this research by examining whether certain drinking motives would mediate the relationship between facets of mindfulness and problematic alcohol use in a sample of 207 college students classified as engaging in problematic drinking. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ), Drinking Motives Questionnaire-Revised (DMQ-R), and Alcohol Use Disorders Identification Test (AUDIT). Results indicated that lower levels of Coping motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score and between greater Nonjudging and lower AUDIT score. Lower levels of Conformity motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score. These findings offer insight into specific mechanisms through which mindfulness is linked to less problematic drinking, and also highlight associations among mindfulness, drinking motives, and alcohol use among a sample of problematic college student drinkers. Future research should determine whether interventions that emphasize Acting with Awareness and Nonjudging facets of mindfulness and/or target coping and conformity motives could be effective for reducing problematic drinking in college students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/

Improve Internet Gaming Disorder with Mindfulness

Improve Internet Gaming Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The conclusion to draw here is that though substances like cocaine are very effective at triggering changes in the brain that lead to addictive behavior and urges, they are not the only possible triggers: just about any deeply pleasurable activity — sex, eating, Internet use — has the potential to become addictive and destructive.” – Howard Markel

 

There are many addictions, from exercise, to alcohol, to sex, to drugs, to gambling, to cigarettes. There are a number of differences produced by the specific nature of each addiction. But, there are also some general features. The core components of addiction include an enhanced incentive for the activity or substance (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased reactivity to stress. Mindfulness training has been shown to be helpful with each of these components, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions.

 

Video game addictions are very common. It is estimated that 72% of American households play some form of video games, with the average use of 20 hours per week. About 9% show signs of addiction to video games while 4% were classified as extreme players who played 50 hours per week or more. The consequences of video game addiction range from “impaired physical health, such as being overweight or obese due to lack of physical activity, sleep disorders, and heightened risk for seizures, depressive and somatic symptoms, social anxiety, and attention-deficit/hyperactivity disorder, substance misuse, driving while playing video games, suicidal ideation, hostility, violence, loss of relationships and employment, and financial debt.”

 

There is thus a need to find safe and effective treatments for gaming addiction that not only help stop the addiction but also prevent relapse.  In today’s Research News article “Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial.” (See summary below) Li and colleagues study the ability of mindfulness practices to treat gaming addiction. They recruited adults who met the requirements for clinical diagnosis of Internet Gaming Disorder and randomly assigned them to 8 weekly 2-hour group sessions of a support group or of Mindfulness-Oriented Enhancement (MORE). The treatment integrates training in mindfulness, cognitive reappraisal skills, and savoring natural rewards. MORE is designed to modify automatic behavioral habits and pleasure dysregulation associated with addictive behaviors. The participants are requested to continue mindfulness practices at home. The participants were measured before and after the 8-week treatment period and were followed-up 3-months later for internet gaming addiction, craving, maladaptive thoughts, mental distress, coping strategies, and mindfulness.

 

They found that both groups showed improvement in internet gaming addiction measures, but the Mindfulness-Oriented Enhancement (MORE) group showed significantly greater improvement than the support group, particularly at the 3-month follow-up. They also found that both groups showed reductions in craving, distraction, catastrophizing, loneliness, and depression, and improved impulse control, acceptance and socialization, but the MORE group showed significantly greater improvement than the support group in craving, loneliness, and depression, particularly at the 3-month follow-up.

 

These exciting results suggest that both a support group and a mindfulness based addition treatment program produced significant improvements in internet gaming addiction. But, the mindfulness treatment produced superior results for improving internet gaming along with reducing cravings for gaming, and improving mood. This was true particularly at the 3-month follow-up suggesting that the mindfulness based addition treatment program produces more long-lasting benefits. This further suggests that MORE may also be superior at preventing relapse.

 

The results add to the list of addictions that can be successfully treated with mindfulness practices. With the number of people engaged in internet gaming and the huge number who become addicted, it is heartening to see that a mindfulness based addition treatment program can be safe and effective, relieving addiction and cravings and improving mood.

 

So, improve internet gaming disorder with mindfulness.

 

“mindfulness can play an important role in ameliorating problem gambling symptomatology.” – Mark Griffiths

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Li, W., Garland, E. L., McGovern, P., O’Brien, J. E., Tronnier, C., & Howard, M. O. (2017, April 24). Mindfulness-Oriented Recovery Enhancement for Internet Gaming Disorder in U.S. Adults: A Stage I Randomized Controlled Trial. Psychology of Addictive Behaviors. Advance online publication. http://dx.doi.org/10.1037/adb0000269

 

Abstract

Empirical studies have identified increasing rates of Internet gaming disorder (IGD) and associated adverse consequences. However, very few evidence-based interventions have been evaluated for IGD or problematic video gaming behaviors. This study evaluated Mindfulness-Oriented Recovery Enhancement (MORE) as a treatment for IGD. Thirty adults (Mage 25.0, SD 5.4) with IGD or problematic video gaming behaviors were randomized to 8 weeks of group-based MORE or 8 weeks of a support group (SG) control condition. Outcome measures were administered at pre- and posttreatment and 3-months following treatment completion using self-report instruments. Linear mixed models were used for outcome analyses. MORE participants had significantly greater reductions in the number of Diagnostic and Statistical Manual of Mental Disorders–5 IGD criteria they met, craving for video gaming, and maladaptive cognitions associated with gaming than SG participants, and therapeutic benefits were maintained at 3-month follow-up. MORE is a promising treatment approach for IGD.

MORE Mindfulness for Stopping Smoking

MORE Mindfulness for Stopping Smoking

 

By John M. de Castro, Ph.D.

 

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort.

 

Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse. But, it is not known how mindfulness produces these beneficial effects. One possibility is that mindfulness training helps to alter how rewarding smoking is, called restructuring reward processes.

 

In today’s Research News article “Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360937/

Froeliger and colleagues examine whether restructuring reward processes is involved in mindfulness training’s effectiveness in aiding smoking cessation. They recruited nicotine-dependent adult smokers who reported smoking more than 10 cigarettes/day for a minimum of 2 years. They separated them into a mindfulness training group and a matched no-treatment control group. Mindfulness training, called Mindfulness-Oriented Recovery Enhancement (MORE) involved 8 weekly sessions, including mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. They were also encouraged to practice at home for 15 minutes per day. The groups were measured for smoking by self-report and breath CO2 measurement, craving to smoke, positive and negative emotions, and mindfulness. Both groups underwent functional Magnetic Resonance Imaging (fMRI) before and after the 8-week training. During scanning they were instructed to imagine feeling positive emotions in response to a picture or to simply look at neutral or smoking related images.

 

They found that MORE mindfulness training significantly reduced cigarette consumption and improved positive emotions following treatment. The fMRI scans revealed significant changes in brain structure and connectivity in the MORE mindfulness training group. While imagining positive reactions to pictures, after, but not before training, the MORE mindfulness trained group evidenced a significantly greater response than the control group in the rostral anterior cingulate cortex and ventral striatum. Conversely, while viewing smoking related images, the MORE mindfulness trained group evidenced a significantly lower response than the control group in the rostral anterior cingulate cortex and ventral striatum. Hence, MORE mindfulness training appeared to restructure the brain increasing brain responses to positive thoughts while decreasing them to smoking stimuli. So, treatment appeared to change the brain making it react more positively to everyday stimuli and more negatively to smoking images, reducing the emotional rewards of smoking.

 

They also found that the larger the brain response to imagining positive emotions to everyday stimuli in the rostral anterior cingulate cortex and ventral striatum the greater the positive emotions and the smaller the craving for cigarettes and the greater the reduction in cigarettes smoked. So, mindfulness training increased the response of these structures resulting in greater positive mood and a lowering of cigarette craving and consumption. This suggests that MORE mindfulness training reduces craving and smoking by changing the brain to produce less positive emotional responses to smoking.

 

These are fascinating results and encourage further, better controlled work than this pilot study that did not have an active control condition. But, the results clearly suggest that mindfulness training is effective in helping nicotine addicts stop smoking and does so by altering the brain to be more positive normally and less positive to smoking. The mindfulness training appeared to restructure the brain making smoking less rewarding and the rest of life more so, leading to reduced smoking.

 

So, MORE mindfulness for stopping smoking.

 

“Early evidence suggests that exercises aimed at increasing self-control, such as mindfulness meditation, can decrease the unconscious influences that motivate a person to smoke,” – Nora Volkow

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Froeliger, B., Mathew, A. R., McConnell, P. A., Eichberg, C., Saladin, M. E., Carpenter, M. J., & Garland, E. L. (2017). Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 7018014. http://doi.org/10.1155/2017/7018014

 

Abstract

The primary goal of this pilot feasibility study was to examine the effects of Mindfulness-Oriented Recovery Enhancement (MORE), a behavioral treatment grounded in dual-process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N = 13; mean (SD) age 49 ± 12.2) smokers provided informed consent to participate in a 10-week study testing MORE versus a comparison group (CG). All participants underwent two fMRI scans: pre-tx and after 8-weeks of MORE. Emotion regulation (ER), smoking cue reactivity (CR), and resting-state functional connectivity (rsFC) were assessed at each fMRI visit; smoking and mood were assessed throughout. As compared to the CG, MORE significantly reduced smoking (d = 2.06) and increased positive affect (d = 2.02). MORE participants evidenced decreased CR-BOLD response in ventral striatum (VS; d = 1.57) and ventral prefrontal cortex (vPFC; d = 1.7) and increased positive ER-BOLD in VS (dVS = 2.13) and vPFC (dvmPFC = 2.66). Importantly, ER was correlated with smoking reduction (r’s = .68 to .91) and increased positive affect (r’s = .52 to .61). These findings provide preliminary evidence that MORE may facilitate the restructuring of reward processes and play a role in treating the pathophysiology of nicotine addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360937/

 

Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

Improve Addiction Rehabilitation with Acceptance and Commitment Group Therapy

 

By John M. de Castro, Ph.D.

 

“ACT looks at a psychological problem in terms of something “physical” in the way, such as a rock that can be moved, or a detour taken around, or a garden plot that needs to be weeded so plants can grow.” – Edie Weinstein

 

Substance abuse and addiction is a terrible problem. It isn’t just illicit drugs but includes many prescriptions drugs especially opioid pain relievers. The over prescription of opioid painkillers in the United States has become a major problem. Opioid abuse, can be deadly. It has become so bad that drug overdose is now the leading cause of injury death, causing more deaths than motor vehicle accidents. This is a problem both of illegal drug use but even more so of abuse of legally obtained prescription drugs. Of the over 44,000 drug overdose deaths in the United States 52% were from prescription drugs. These statistics, although startling, are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not. It also reduces life expectancy by about 15-20 years from the moment of addiction. An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates.

 

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 Narcotics 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 not only produce abstinence but also prevent relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. On the face of it, ACT would appear to address the kinds of defective thought processes that occur in addiction. But, the effectiveness of ACT for opioid addiction has not been adequately tested.

 

In today’s Research News article “Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

Azkhosh and colleagues recruited individuals who were addicted to opiates and randomly assigned them to receive either a group administered Acceptance and Commitment Therapy (ACT), Narcotics Anonymous 12-step program, or usual treatment. Treatment occurred for 12 weeks, meeting once a week for 90 minutes. Before and after treatment and 6 weeks later the participants were measured for psychological wellbeing, and psychological flexibility.

 

They found that at the end of treatment and at follow-up, both treatment groups showed improvements relative to the control group on psychological well-being and psychological flexibility, including the self-acceptance, autonomy, purpose in life, and personal growth subscales. Hence, both Acceptance and Commitment Therapy (ACT) and Narcotics Anonymous 12-step programs improve the psychological components that are needed for successful treatment of opioid addiction. It remains for future research to determine if these effects translate into successful primary treatment and relapse prevention of opioid addiction.

 

So, improve the psychological characteristics needed for addiction rehabilitation with Acceptance and Commitment Therapy.

 

“ACT encourages people to simply notice and accept their thoughts and feelings for what they are: merely thoughts and feelings of no particular importance other than the importance we assign them. People learn to say to themselves, “Oh, I’m having a thought about cocaine. I’m having a feeling it would be fun to use again.” From this perspective, there is no impetus to use cocaine, nor is cocaine fun. It is merely a thought about those things.” – Tom Horvath

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Azkhosh, M., Farhoudianm, A., Saadati, H., Shoaee, F., & Lashani, L. (2016). Comparing Acceptance and Commitment Group Therapy and 12-Steps Narcotics Anonymous in Addict’s Rehabilitation Process: A Randomized Controlled Trial. Iranian Journal of Psychiatry, 11(4), 244–249.

 

Abstract

Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran.

Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance.

Results: Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P<0.05) and that acceptance and commitment therapy group showed improvement relative to the NA and control groups on psychological well-being and psychological flexibility.

Conclusion: The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206327/

 

Improve Substance Abuse Treatment with Mindfulness

Improve Substance Abuse Treatment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is most often the mind’s interpretation of a stressful life event, not the event itself, that creates the urgent need to get instant relief and leads to substance use or other unwanted behaviors. Mindfulness practices provide a break from stress, teach the client to listen to his/her mind, body, and emotions, and improve the self-acceptance that leads to greater hope and self-efficacy.“ – NAADAC

 

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. Drug abuse is often more complex than a simple addiction to a substance. Addiction frequently is accompanied by other mental health issues, comorbidities. They include mood and anxiety disorders, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD).

 

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, possibility because of the failure to address comorbidities. Hence, it is important to find an effective method to treat both addiction but also accompanying conditions. Mindfulness training has been shown to be a safe and effective treatment of addiction and relapse prevention. It has also been shown to be effective for a variety of other mental health issues including anxiety, depression, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD). Hence, mindfulness training would appear to be a potential treatment that can be added to traditional substance abuse treatment programs to both address addiction and accompanying comorbid disorders.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

Garland and colleagues compared the effectiveness of a mindfulness-based addiction treatment program with another well-established therapy, cognitive behavioral therapy (CBT), and with the usual treatment for addiction. They recruited homeless men with a substance abuse disorder and comorbid mental health issues and randomly assigned them to either receive 10 weeks of a group-based Mindfulness-Oriented Recovery Enhancement (MORE) program, group-based cognitive behavioral therapy (CBT), or usual treatment. At the beginning and end of the 10-week treatment, they measured the participants’ trauma history, drug cravings, post-traumatic stress symptoms, psychiatric distress, mindfulness, positive and negative feelings, and readiness to change.

 

They found that all treatments improved depression, but Mindfulness-Oriented Recovery Enhancement (MORE) treatment produced improvements in drug cravings, post-traumatic stress symptoms, mindfulness, and negative feelings, that were significantly greater than cognitive behavioral therapy (CBT), or usual treatment. In addition, mediation analysis revealed that the improvements in drug cravings and post-traumatic stress symptoms was mediated by increases in mindfulness. That is the Mindfulness-Oriented Recovery Enhancement (MORE) treatment significantly improved mindfulness which, in turn, produced significant improvements in drug cravings and post-traumatic stress symptoms.

 

These are particularly compelling findings as MORE was found to be superior to a well-established treatment technique, cognitive behavioral therapy (CBT). This is a powerful research design that controls for most sources of confounding. So, it appears clear that adding mindfulness practice to addiction treatment significantly improves outcomes.

 

So, improve substance abuse treatment with mindfulness.

 

“mindfulness enhances our ability to be non-reactive. This is key in drug treatment because oftentimes we seek immediate gratification; we want to feel good right now, or we want the negative feeling we’re experiencing to stop right now. This leads to reactive thinking, feeling, and behaving, and can be a catapult for drug use. When we practice mindfulness we practice responding to our experience with a non-reactive, non-judgmental attitude. This helps us maintain autonomy over our behavior. We may not have control over whether a craving for a drug arises, but we can control how we respond to such a craving. The irony is that when we practice simply observing the craving; letting it arise and letting it pass away (rather than actively trying to push it away or avoid it), we are left with more of an ability to regulate ourselves.´- Center for Adolescent Studies

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Garland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016). Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial. Behaviour Research and Therapy, 77, 7–16. http://doi.org/10.1016/j.brat.2015.11.012

 

Abstract

In clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. As such, transdiagnostic therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n=64), CBT (n=64), or TAU (n=52). Study findings indicated that from pre- to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and significantly greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/