Improve Substance Abuse Disorders with Mindfulness-Based Treatments

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

 

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

 

Study Summary

 

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

 

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392831/

 

Mindfulness is Negatively Related to Compulsive Sexual Behavior in Adults Undergoing Substance Abuse Treatment

Mindfulness is Negatively Related to Compulsive Sexual Behavior in Adults Undergoing Substance Abuse Treatment

 

By John M. de Castro, Ph.D.

 

Stress contributes to many sex problems. Mindfulness helps by reducing stress.” – Michael Castleman

 

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. Indeed, mindfulness has been shown to be related to compulsive sexual behavior in men undergoing treatment for substance abuse. This suggests that further study of the relationship between mindfulness and compulsive sexual behavior with men and women should be investigated.

 

In today’s Research News article “Exploring Gender Differences in the Relationship between Dispositional Mindfulness and Compulsive Sexual Behavior among Adults in Residential Substance Use Treatment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884324/) Brem and colleagues examined the records for patients admitted into residential substance abuse treatment facilities. The completed measures of alcohol use and problems, drug use and problems, and psychiatric symptomology. Mindfulness was measured over 5 domains: acting with awareness, observation of experience, describing with words, non-judging of inner experience, and non-reactivity to inner experience). Compulsive sexual behavior was measured over five domains: preoccupation, loss of control, affect disturbance, relationship disturbance, and internet problems.

 

They found that high levels of mindfulness facets were associated with low levels of compulsive sexual behavior. But the relationships differed between men and women. In particular, for men, the mindfulness facets of acting with awareness, nonjudging of inner experience, describing with words, and non-reactivity to inner experience were significantly negatively related to compulsive sexual behavior, while for women for men, the mindfulness facets of acting with awareness, nonjudging of inner experience were significantly negatively related to compulsive sexual behavior. For both men and women alcohol use and problems, drug use and problems, and depression were positively related to compulsive sexual behavior.

 

These results are interesting but correlational, so caution must be exercised in reaching conclusions regarding causation. But they do suggest that for men describing with words, and non-reactivity to inner experience are more important than for women in being related to compulsive sexual behavior.

 

This further suggests that compulsive sexual behavior occurs predominantly without real time awareness and hence mindfulness may be an important antidote to compulsive sexual behavior. But what facets of mindfulness are most important differs between the genders. So, in developing therapeutic programs for the treatment of substance abuse disorders, mindfulness training programs might be tailored differently for men and women.

 

So, mindfulness is negatively related to compulsive sexual behavior in adults undergoing substance abuse treatment.

 

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

               

Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2019). Exploring Gender Differences in the Relationship between Dispositional Mindfulness and Compulsive Sexual Behavior among Adults in Residential Substance Use Treatment. Mindfulness, 10(8), 1592–1602. https://doi.org/10.1007/s12671-019-01117-7

 

Abstract

Objectives:

Compulsive sexual behavior (CSB) is overrepresented among adults with substance use disorders (SUD), yet there is no empirically supported CSB treatment for this population. Cross-sectional and single case designs supported dispositional mindfulness as a potential CSB intervention target. However, the relations between CSB and each of the five dispositional mindfulness facets remain unknown.

Methods:

Extending prior research to inform intervention efforts, we reviewed medical records for 1993 adults (77.6% male) in residential treatment for SUD to examine gender differences in the relations between dispositional mindfulness facets (acting with awareness, observation of experience, describing with words, non-judging of inner experience, and non-reactivity to inner experience) and five CSB indicators (loss of control, relationship disturbance, preoccupation, affect disturbance, and internet problems).

Results:

For men, path analyses revealed that acting with awareness, nonjudging of inner experience, describing with words, non-reactivity to inner experience, alcohol/drug use and problems, and depression and anxiety symptoms related to CSB (p range: .00-.04). For women, acting with awareness, non-judging of inner experience, alcohol/drug use and problems, and depression symptoms related to several CSB indicators (p range: .00-.04).

Conclusions:

Mindfulness-based CSB interventions should evaluate the benefit of increasing intentional responses towards present-moment experiences among adults with SUD. Targeting alcohol/drug misuse, negative affect, and judgement towards thoughts and emotions may be beneficial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884324/

 

Reduce Internet Addiction with Mindfulness

Reduce Internet Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

teaching teens to be mindful—through exercises or school programs—might help prevent and treat our modern digital obsession.” – Kira Newman

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravingsimpulsiveness, 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. It also has been found to be helpful in overcoming internet and smartphone addictions. But there is a need to further explore the effectiveness of mindfulness training on internet addiction.

 

In today’s Research News article “Reducing compulsive Internet use and anxiety symptoms via two brief interventions: A comparison between mindfulness and gradual muscle relaxation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044623/) Quinones and colleagues recruited adults who lived with a partner, worked more than 40 hours per week, and showed signs of compulsive internet use. They were randomly assigned to a wait-list control group, a mindfulness group, or a gradual relaxation group. The interventions were delivered by 10-minute podcasts of either mindfulness (Headspace) or relaxation daily for 2 weeks. The participants were measured before and after training for compulsive internet use, anxiety, depression, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group both the mindfulness and relaxation groups had significant reductions in anxiety and depression. Only the mindfulness group had a significant increase in mindfulness. Although both the mindfulness and relaxation groups had significant reductions in compulsive internet use, the mindfulness group had a significantly greater reduction than the relaxation group.

 

These results suggest that a brief, simple, online training in mindfulness produces greater immediate increases in mindfulness and reductions in compulsive internet use than relaxation training. Both interventions were effective in reducing the negative emotions of anxiety and depression. There is a need, however, to follow-up these findings to determine if the effects are lasting or only temporary immediately after training. But these findings are encouraging and suggest that further research is warranted.

 

Compulsive internet use is a new phenomenon but like other addictions and compulsions is disruptive of the individual’s life. It is unknown how mindfulness influences compulsive internet use. But it can be speculated that training in paying attention to the present moment may allow for other aspects of life to break into the compulsive focus on the internet and thereby disrupt the compulsion.

 

So, reduce internet addiction with mindfulness.

 

“just as technology is increasingly being developed to attract and hold our attention, with mindfulness we can develop the capability to be much more aware of where the spotlight of our attention is being drawn to, and consciously choose to direct and place our attention and energy on an activity of our choosing.” – Neil Trantor

 

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

 

Quinones, C., & Griffiths, M. D. (2019). Reducing compulsive Internet use and anxiety symptoms via two brief interventions: A comparison between mindfulness and gradual muscle relaxation. Journal of behavioral addictions, 8(3), 530–536. https://doi.org/10.1556/2006.8.2019.45

 

Abstract

Background

Compulsive Internet use (CIU) refers to those individuals who experience a loss of control regarding their online use. Although suffered by a minority, a much larger proportion of adults report to be experiencing early signs of CIU, which can become more problematic if sustained over time, especially when used as a coping mechanism for stress. Since compulsive behaviors are characterized by executing behaviors on “automatic pilot,” mindfulness techniques, which help individuals relate more consciously with their environment, could help develop a more adaptive relationship with technology. However, mindfulness interventions are often lengthy hence not ideal for busy individuals with early signs of CIU.

Aims

This study tested the effectiveness of a brief mindfulness intervention (10 min a day for 2 weeks) to reduce CIU and anxiety and depression symptoms, in relation to an equivalent length classic arousal descending technique (i.e., gradual-muscle-relaxation), and a wait-list control group.

Methods

A randomized controlled trial (RCT) was used with assessments at pre- and post-phases. Participants showing initial signs of CIU were allocated to a mindfulness-group (n = 343), gradual-relaxation (n = 301), or a wait-list control group (n = 350).

Results

The mindfulness and gradual-muscle-relaxation participants were equally effective in reducing anxiety and depression. The mindfulness intervention was more effective reducing CIU symptoms.

Discussion

Given the large sample sizes of this RCT, these results are promising, although follow-up studies are needed. Considering health hazards of the “always-on-culture” and the popularity of bite-sized learning, the effectiveness of easy-to fit-in daily life health practices is a positive development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044623/

 

Meditation Alters a Variety of Biological Mechanisms and Improves Mental Disorders

Meditation Alters a Variety of Biological Mechanisms and Improves Mental Disorders

 

By John M. de Castro, Ph.D.

 

Meditation-which come in many variations-has long been acknowledged as a tool to master the mind and cope with stress. Science is increasingly validating those claims, especially for depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder).” – Mental Health America

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. There are a number of ways that meditation practices produce these benefits, including changes to the brain and physiology. It is useful to review and summarize what has been discovered regarding the mechanisms by which meditation practice improves mental disorders.

 

In today’s Research News article “Biological mechanism study of meditation and its application in mental disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359050/) Shen and colleagues review and summarize the published scientific research studies on the mechanisms by which meditation practice improves mental disorders.

 

They report that the published research has found complex and widespread changes in the nervous system occur as a result of meditation. In the central nervous system these are relatively long lasting changes in the amount and connectivity of the brain tissue, termed neuroplastic changes, and these may underlie the beneficial changes in the meditators. In addition, meditation appears to alter the peripheral nervous system, in particular, the autonomic nervous system. Meditation increases parasympathetic activity that underlies vegetative functions and relaxation. This may be one mechanism by which meditation improves stress responses.

 

They further report that the published research found that meditation improves the functions of the immune and inflammatory systems. These effects also improve stress responses and fighting off disease. Hence, the effects of meditation on these biological process may underlie meditations ability to improve health. Since inflammatory responses often accompany mental illnesses, this may also be a mechanism by which meditation improved mental disease.

 

On a genetic, microbiological, level meditation has been found to alter the expression of genes that promote health. This may be the underlying reason that meditation improves the immune and inflammatory systems. Also, on the genetic level the research has found that meditation promotes the preservation of telomeres. These are the ends of the chromosomes that shorten throughout the lifetime and are thought to perhaps underlie cellular aging. This mechanism may underlie meditation’s ability to slow the aging process.

 

Meditation has been found through systematic controlled research to improve a wide array of mental illnesses. These include depression, including major depressive disorders, Post-traumatic stress disorder (PTSD), Attention Deficit Hyperactivity Disorder (ADHD), and Schizophrenia. In addition, meditation has been found to aid in recovery from substance abuse disorders and to help prevent relapse.

 

It is clear from the published scientific research that meditation alters a wide array of physiological processes and improves and improves an equally wide array of mental illnesses. It will be important in the future to link the two to begin to understand what physiological changes underlie which improvements in mental illness. Regardless it is clear that meditation has many beneficial effects that promote physical and mental well-being.

 

So, practice meditation to alter a variety of biological mechanisms and improve mental disorders.

 

Mindfulness exercises are valuable and useful for anyone, but most especially for people who are struggling with mental illness or addictions. “ – Sarah Levin

 

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

 

Shen, H., Chen, M., & Cui, D. (2020). Biological mechanism study of meditation and its application in mental disorders. General psychiatry, 33(4), e100214. https://doi.org/10.1136/gpsych-2020-100214

 

Abstract

In recent years, research on meditation as an important alternative therapy has developed rapidly and been widely applied in clinical medicine. Mechanism studies of meditation have also developed progressively, showing that meditation has great impact on brain structure and function, and epigenetic and telomere regulation. In line with this, the application of meditation has gradually been expanded to mental illness, most often applied for major depressive disorders and substance-related and addictive disorders. The focus of this paper is to illustrate the biological mechanisms of meditation and its application in mental disorders.

Conclusions

Over the past two decades, meditation has been used in a great variety of fields to relieve stress, regulate emotions and promote physical and mental health. In recent years, the application of meditation in the psychiatric field has gradually received attention. It has become an adjunctive and alternative therapy for depression, PTSD and ADHD and has been carried out for the acute and remission stages of treatment for severe schizophrenia. Additionally, it can ameliorate emotional distress, craving and withdrawal symptoms in substance addiction. However, the current researchers adopt different meditation methods and diverse training durations, which leads to the inability to systematically evaluate which type of meditation is more beneficial to which populations or diseases, and to completely elucidate the biological mechanism of meditation. In the future, further targets for selective meditation subtypes along with prescribed training time, and randomised controlled studies with sufficient samples are required to determine the efficacy of meditation on the one hand, and simultaneously study the mechanisms behind meditation on the mind–body interaction, which can better display the positive function of meditation as an ancient physical and mental healing method in promoting human health.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359050/

 

Improve Recovery from Substance Abuse with Rolling Mindfulness Training

Improve Recovery from Substance Abuse with Rolling Mindfulness Training

 

By John M. de Castro, Ph.D.

 

By facilitating conscious awareness with a nonjudgmental perspective, mindfulness can decrease the vicious circles of anxiety, fear, anger, sadness, depression, guilt, regret, and shame that make so many recovering people vulnerable to relapse.” – Dan Mager

 

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.

 

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

 

Typically, Mindfulness-based Relapse Prevention (MBRP) is administered with a group together from start to end. In practice in residential treatment programs, however, individuals enter treatment at different times. It would be important to examine whether MBRP with rolling admissions, where participants enter the therapy program at different times, is effective in treating substance abuse patients.

 

In today’s Research News article “An open trial of rolling admission mindfulness-based relapse prevention (Rolling MBRP): feasibility, acceptability, dose-response relations, and mechanisms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660179/) Roos and colleagues recruited residents in a short-term residential substance abuse disorders treatment program. They were provided 50 minute, twice per week, for 8 weeks group Mindfulness-based Relapse Prevention (MBRP) program. Participants could enter the program at any time during a 10-month period. They were measured before and after treatment for abstinent days, dependence severity, self-compassion, mindfulness, mental health, craving, and self-efficacy.

 

They found that the participants completed, on average, 3.69 sessions and the participants rated the sessions as very helpful. They found that in comparison to baseline and patients who did not participate, the rolling Mindfulness-based Relapse Prevention (MBRP) group had significantly decreased cravings, and increased mental health, mindfulness, and self-compassion. In addition, for attendees, the greater the amounts of formal and informal mindfulness practice, the greater the improvements in cravings, mental health, mindfulness, and self-compassion.

 

Prior studies demonstrated that mindfulness training improves mental health and self-compassion and is effective in improving the mental health of patients with a variety of addictions and in preventing substance abuse relapse. The present study is important in demonstrating that Mindfulness-based Relapse Prevention (MBRP) offered on a rolling basis is also effective. Such a rolling entry treatment program is better suited to the intake of patients in residential substance abuse treatment programs and makes MBRP more useable in these programs.

 

So, improve recovery from substance abuse with rolling mindfulness training.

 

Learning about your personal triggers, developing the ability to breathe through discomfort, and creating a mindfulness based lifestyle in recovery can be lifesavers in both early sobriety and throughout the rest of your life.” -Clear Mind Treatment

 

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

 

Roos, C., Kirouac, M., Stein, E., Wilson, A., Bowen, S., & Witkiewitz, K. (2019). An open trial of rolling admission mindfulness-based relapse prevention (Rolling MBRP): feasibility, acceptability, dose-response relations, and mechanisms. Mindfulness, 10(6), 1062–1073. https://doi.org/10.1007/s12671-018-1054-5

 

Abstract

Mindfulness-based relapse prevention (MBRP) is an effective treatment for substance use disorders (SUD). However, evidence is primarily based on studies of closed groups, and few studies support flexible formats of MBRP, such as rolling groups. This nonrandomized, open trial evaluated feasibility, acceptability, dose-response relations, and mechanisms of rolling admission MBRP (“Rolling MBRP”) offered as part of short-term residential treatment for SUD. Rolling MBRP was developed prior to the trial through an iterative process over several years. Participants included 109 adults (46% female, 74.3% racial/ethnic minorities, mean age=36.40). Rolling MBRP was offered to all patients in the program 2x/week and attendance was tracked. Outcomes were craving, self-efficacy, mental health, mindfulness, and self-compassion at discharge. Self-reported out-of-session mindfulness practice was examined as a mediator of attendance-outcome relations. Analyses involved multiple regression and mediation models. Feasibility was demonstrated by good attendance rates. Acceptability was demonstrated by high engagement in mindfulness practice and high satisfaction ratings. Total sessions attended did not predict outcomes at discharge. However, attending 2+ sessions (versus 1 or none) significantly predicted better mental health and higher mindfulness at discharge, and these effects were mediated by informal and formal mindfulness practice. Total sessions attended had significant indirect effects on craving, self-compassion, mindfulness, and mental health, via mindfulness practice. Results support the feasibility and acceptability of Rolling MBRP and suggest mindfulness practice may be a key mechanism driving effects of MBRP on other key mechanisms during the recovery process, such as decreased craving and improved mental health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660179/

 

Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

 

By John M. de Castro, Ph.D.

 

over a third of us check our phones in the middle of the night. And a further third check our phones within five minutes of waking up. The same survey also revealed that about a third of us have argued with our partners about using their phones too much.” – Neil Tranter

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. The dominant mode of accessing the internet is through smartphones creating smartphone addictions. Individuals with smartphone addiction develop greater levels of “tolerance” and experience “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges and stresses. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and stressed and unable to cope with all that is required.

 

Mindfulness training has been shown to be helpful with addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be effective for the treatment of a variety of addictions. Meditation, a core mindfulness training technique, has been shown to be effective in treating addictions. Hence, there is a need to further explore the ability of meditation training to treat smartphone addiction in adolescents.

 

In today’s Research News article “The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/), Choi and colleagues recruited High School sophomores at two different schools and provided one group with school based meditation training for 20 minutes twice a week for 12 weeks while the second group received no treatment. They were measured before and after training and 4 weeks later for smartphone addiction, self-control, perceived stress, and stress coping skills.

 

They found that after treatment the meditation but not the control group had a significant reduction in perceived stress and smartphone addiction, including decreases in daily life disturbance, tolerance, and withdrawal symptoms. They also found significant increases in self-control and stress coping strategies including problem focusing coping and social support navigation coping. They also found that theses effects were still present and significant 4 weeks after the end of training.

 

These are interesting results that would have been stronger is an active control condition such as exercise was used. Nevertheless, the results suggest that school-based meditation practice can reduce stress, improve stress coping and self-control and decrease addiction to smartphones in adolescents. This should help these young people to better deal with their school stress and be better able to perform academically and socially.

 

So, reduce smartphone addiction and improve stress coping in adolescents with meditation.

 

These devices and capabilities do bring incredible benefits and possibilities for sharing information and creating global interaction than ever before. We simply (and yet with great difficulty) need to learn to hold our technology more lightly—with more awareness.” – Mitch Abblett

 

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

 

Choi, E. H., Chun, M. Y., Lee, I., Yoo, Y. G., & Kim, M. J. (2020). The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents. International journal of environmental research and public health, 17(9), 3263. https://doi.org/10.3390/ijerph17093263

 

Abstract

As the smartphone has become an indispensable device in modern lives, consequential psychosocial problems such as smartphone addiction have been getting attention worldwide, especially regarding adolescents. Based on its positive effect on young individuals’ mental health, mind subtraction meditation has been widely applied to many school-based programs in South Korea. This study aims to identify the effects of a school program based on mind subtraction on the smartphone addiction of adolescents. A total of 49 high school sophomores, 24 from the experimental group (mean age = 16), and 25 from the control group (mean age = 16) are included in this case-control study. The experimental group is given the meditation program sessions in the morning, two times a week for 20 min per session, for a total of 12 weeks. The experimental group shows improvements regarding the ‘smartphone addiction’ section (p < 0.001), for instant satisfaction (p < 0.001) and long-term satisfaction (p < 0.001). Concerning the ‘self-control’ section and decreasing stress (p < 0.001), problem focusing (p < 0.001), and social support navigation (p = 0.018), there are improvements in these ‘stress coping strategies’ sections. This study directly shows the positive effect of mind subtraction meditation on smartphone addiction in adolescents and, thus, provides guidance to the future development of smartphone addiction prevention programs for young individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/

 

Adherence to a Mindfulness Intervention Assists in Preventing Alcoholism Relapse

Adherence to a Mindfulness Intervention Assists in Preventing Alcoholism Relapse

 

By John M. de Castro, Ph.D.

 

“Thoughts and feelings, including urges to use substances or activities, are always temporary. Through mindfulness and its related practices (including meditation) it is possible to learn how to face uncomfortable, painful thoughts, feelings, and physical sensations, and let them pass—without obsessing on or avoiding them.” – Dan Mager

 

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.

 

Obviously, there is a need to find effective methods to prevent and treat alcohol abuse. There are a number of programs that are successful at stopping the abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of alcohol abusers relapse and return to drinking. Hence, it is important to find an effective method to both treat alcohol abuse and to prevent relapse. Mindfulness practices have been shown to improve recovery from various addictions and reduce relapse. Mindfulness training has been successfully applied to treating alcohol abuse. It appears to increase the ability of the drinker to control alcohol intake. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to examine the ability of mindfulness training to reduce relapse after successful cessation.

 

In today’s Research News article “Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508889/), Zgierska and colleagues recruited alcohol dependent adults who were in early recovery in an alcohol treatment program. They were randomly assigned to either continue to receive their current treatment or to receive an 8 weekly 2-hour Mindfulness-Based Relapse Prevention (MBRP) program with home practice tailored for alcohol abuse. They were measured before and after treatment and a year later for alcohol consumption, drinking-related consequences, mindfulness, and perceived stress.

 

They reported that over the one-year follow-up period there were no significant differences between the treatment as usual or the Mindfulness-Based Relapse Prevention (MBRP) participants on any of the outcome measures. But, for the MBRP participants who attended at least 4 sessions, the greater the number of sessions attended, and the greater the amount of home practice the lower the percentage of drinking days and the fewer the heavy drinking days during the 1-year follow-up.

 

The results of the present study are surprising as prior research has consistently demonstrated that mindfulness training improves relapse prevention. The present findings may have been due to a ceiling effect. The participants in both groups were committed to stopping drinking and already had up to 14 days of sobriety prior to entry into the study. This was reflected in that 60% of the participants in both groups were abstinent at the 1-year follow-up. This is an exceptionally high success rate for alcohol relapse prevention. So, the treatment as usual group may have been so successful that it left little room for the Mindfulness-Based Relapse Prevention (MBRP) participants to show any further improvement.

 

The results of the present study indicate that participation in the program and adherence to the program requirements are exceptionally important. After taking out those non-adherent participants there was a positive relationship between adherence and relapse prevention.

 

So, adherence to a mindfulness intervention assists in preventing alcoholism relapse.

 

“We need to consider many different approaches to addiction treatment. It’s a tough problem,” Mindfulness therapy is “another possibility for people to explore,” – 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

 

Zgierska, A. E., Burzinski, C. A., Mundt, M. P., McClintock, A. S., Cox, J., Coe, C. L., Miller, M. M., & Fleming, M. F. (2019). Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial. Journal of substance abuse treatment, 100, 8–17. https://doi.org/10.1016/j.jsat.2019.01.013

 

Highlights

MBRP-A plus usual care and usual care alone resulted in similar health benefits.

Addition of MBRP-A to usual care did not further improve drinking-related outcomes.

Greater MBRP-A intervention adherence was associated with better outcomes.

Abstract

OBJECTIVES:

To assess the effects of mindfulness-based relapse prevention for alcohol dependence (MBRP-A) intervention on drinking and related consequences.

METHODS:

123 alcohol-dependent adults in early recovery, recruited from outpatient treatment programs, were randomly assigned to MBRP-A (intervention plus usual-care; N=64) or Control (usual-care-alone; N=59) group. MBRP-A consisted of eight-weekly sessions and home practice. Outcomes were assessed at baseline, 8 weeks and 26 weeks (18 weeks post-intervention), and compared between groups using repeated measures analysis.

RESULTS:

Outcome analysis included 112 participants (57 MBRP-A; 55 Control) who provided follow-up data. Participants were 41.0±12.2 years old, 56.2% male, and 91% white. Prior to “quit date,” they reported drinking on 59.4±34.8% (averaging 6.1±5.0 drinks/day) and heavy drinking (HD) on 50.4±35.5% of days. Their drinking reduced after the “quit date” (before enrollment) to 0.4±1.7% (HD: 0.1±0.7%) of days. At 26 weeks, the MBRP-A and control groups reported any drinking on 11.5±22.5% and 5.9±11.6% of days and HD on 4.5±9.3% and 3.2±8.7% of days, respectively, without between-group differences (ps≥0.05) in drinking or related consequences during the follow-up period. Three MBRP-A participants reported “relapse,” defined as three-consecutive HD days, during the study. Subgroup analysis indicated that greater adherence to session attendance and weekly home practice minutes were associated with improved outcomes.

CONCLUSIONS:

MBRP-A as an adjunct to usual-care did not show to improve outcomes in alcohol-dependent adults in early recovery compared to usual-care-alone; a return to drinking and relapse to HD were rare in both groups. However, greater adherence to MBRP-A intervention may improve long-term drinking-related outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508889/

 

Improve Smoking Abstinence with Mindfulness

Improve Smoking Abstinence with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness training (MT) may decouple the association between craving and smoking, thus facilitating smoking cessation.” – J. Kim Pemberthy

 

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 “Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/), Spears and colleagues recruited adult smokers desiring to quit and provided them with “six smoking cessation counseling sessions (10–20 minutes each).” They completed questionnaires on demographics and mindfulness. They were also asked to complete assessments at baseline and for 4 weeks after cessation of smoking on a smartphone of positive and negative emotions, smoking urges, and expectancy of regulating emotions whenever they had an urge to smoke, smoked a cigarette, and 4 randomly selected times per day prompted on their smartphone.

 

Of the participants 63% achieved smoking abstinence after treatment and 41% remained abstinent 7 days later. They found that on the day of smoking cessation and 7 days later, the higher the levels of mindfulness the lower the levels of negative emotions, stress, smoking urges, and expectancies that smoking would improve mood and the higher the levels of positive emotions. They also found that lower smoking urges were associated with higher levels of abstinence when the participants were low in mindfulness but not when they were high in mindfulness. In addition, the higher the levels of mindfulness, the higher the levels of positive emotions and the lower the levels of negative emotions which were in turn associated with higher levels of smoking abstinence.

 

Even though the smoking cessation therapy did not include a mindfulness component, the participant’s level of mindfulness was an important contributor to successful smoking abstinence. Mindfulness appeared to be associated with improved mood and lower stress levels and urges to smoke which were in turn associated with improved outcomes. Hence, mood and stress appear to mediate the association of mindfulness with successfully quitting smoking. Mindful people appear to have more positive moods which works to improve the likelihood of quitting smoking.

 

So, improve smoking abstinence with mindfulness.

 

stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

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

 

Spears, C. A., Li, L., Wu, C., Vinci, C., Heppner, W. L., Hoover, D. S., Lam, C., & Wetter, D. W. (2019). Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 33(3), 197–207. https://doi.org/10.1037/adb0000451

 

Abstract

Research suggests that individuals with greater dispositional mindfulness (i.e., non-judgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days pre-quit and 1 week post-quit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each pre-quit and post-quit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days post-quit, as well as indirect effects of mindfulness on abstinence through EMA parameters were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad and angry, mediated the association between mindfulness and post-quit abstinence. Mindfulness appeared to weaken the association between craving and post-quit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appear to have more favorable emotional profiles, which predicts higher likelihood of achieving abstinence 1 week after the quit date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/

 

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

Mindfulness, doi:10.1007/s12671-018-1023-z

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

 

By John M. de Castro, Ph.D.

 

“when people cultivate mindfulness, they’re developing a tool to become aware of that inclination to want only pleasurable things and escape uncomfortable things.” – 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. 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.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings. 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 a previous study it was reported that Mindfulness-based Relapse Prevention (MBRP) improved mindfulness which in turn resulted in reduced cravings. In today’s Research News article “The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/), Hsiao and colleagues attempted to replicate their previous findings of mindfulness as a mediator between MBRP and reduced cravings. They recruited adults who had completed intensive treatment for cessation of alcohol or drug abuse in the prior 2 weeks. The patients were randomly assigned to receive either treatment as usual or 8 weekly 2-hour sessions of Mindfulness-based Relapse Prevention (MBRP). They were measured before and after training and 2 and 4 months later for acceptance, mindfulness and drug or alcohol cravings.

 

In a previous, virtually identical study, they had found that in comparison to baseline and treatment as usual Mindfulness-based Relapse Prevention (MBRP) resulted in significantly increased mindfulness and acceptance and decreased cravings. They also found that mindfulness mediated the effect of MBRP on cravings such that MBRP increased mindfulness which in turn decreased cravings. But in the present study MBRP did not increase mindfulness and acceptance and did not decrease cravings and there was no significant mediation.

 

These were surprising results. The previous study was highly significant with moderate effect sizes. They hypothesized that part of the failure to replicate the prior results may have been due to the increased acceptance of mindfulness in the therapeutic community over the years. They speculated that mindfulness may have been incorporated in the therapy included in treatment as usual in the present study whereas it wasn’t in the prior study. More research is needed to examine this possibility.

 

It should be noted that the effectiveness of mindfulness in producing benefits has been replicated multiple times in other domains. Thus, the results underline the need for replication of published results in the studies of mindfulness and addiction. They may be more fragile than thought.

 

One of the biggest challenges of recovering from addiction is dealing with cravings. . . Being mindful in a craving means seeing the craving for what it really is and really experiencing it. . . Once you can accept that a craving is just a feeling and the object of the craving will never deliver on that promise, you will be able to regain some control.” – Recovery Ways

 

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

 

Hsiao, Y. Y., Tofighi, D., Kruger, E. S., Lee Van Horn, M., MacKinnon, D. P., & Witkiewitz, K. (2019). The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders. Mindfulness, 10(4), 724–736. https://doi.org/10.1007/s12671-018-1023-z

 

Abstract

The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness. There is also concern about the reproducibility of findings given few attempts at replication. The current secondary analysis addressed the issue of reproducibility and robustness of the construct of self-reported mindfulness across two separate randomized clinical trials of mindfulness-based relapse prevention (MBRP), as an aftercare treatment for substance use disorder. Specifically, we tested the robustness of our previously published findings, which identified a latent construct of mindfulness as a significant mediator of the effect of MBRP on reducing craving following treatment. First, we attempted to replicate the findings in a separate randomized clinical trial of MBRP. Second, we conducted sensitivity analyses to test the assumption of the no-omitted confounder bias in a mediation model. The effect of MBRP on self-reported mindfulness and overall mediation effect failed to replicate in a new sample. The effect of self-reported mindfulness in predicting craving following treatment did replicate and was robust to the no-omitted confounder bias. The results of this work shine a light on the difficulties in the measurement of mindfulness and the importance of examining the robustness of findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/

 

Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain.” – Science Daily

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. 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.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings for opioids. It may also do so by affecting the ability of the addict to regulate their emotions. Indeed, mindfulness has been shown to improve emotional regulation.

 

In today’s Research News article “Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/), Baker and Garland recruited non-cancer chronic pain patients who were taking opioid analgesics and had them complete self-report measures of mindfulness, opioid craving, and depression. They also measured their heart rates with an electrocardiogram (ECG) while looking at either neutral pictures or “opioid-related image (e.g., pills, pill bottles).” These data were analyzed to determine heart rate variability as a measure of the activity of the peripheral autonomic nervous system.

 

They found that the higher the levels of mindfulness the higher the levels of heart rate variability while looking at opioid-related pictures. And the lower the levels of depression and opioid cravings. Also, the higher the levels of depression, the higher the levels of opioid cravings. Employing a multivariate path analysis, they found that mindfulness was not associated with lower opioid cravings directly, but indirectly via mindfulness’ associations with heart rate variability and depression. That is, they found that mindfulness was associated with higher heart rate variability which was in turn associated with lower opioid cravings and also with lower depression which was in turn associated with lower opioid cravings.

 

Heart rate variability is thought to measure the nervous systems adjustments to the physiology involved in regulating its physical responses to stimuli. In other words, it’s a measure of self-regulation. The present results suggest that mindfulness is associated with greater self-regulation and this is associated with lower cravings for opioids. The results also suggest that depression is associated with higher cravings for opioids and that mindfulness interrupts this by being associated with lower depression.

 

These results are correlative and as such causation cannot be determined. Nevertheless, prior research has demonstrated causal links between mindfulness and lower cravings and depression. So, the present results likely result from causal connections. The findings also suggest the mechanism whereby mindfulness may lower cravings by contributing to the ability to regulate physical responses to opioid-related stimuli and by reducing depression. These results provide more support for the use of mindfulness training as a treatment for addictions.

 

So, lower opioid cravings are associated with lower depression, higher self-regulation, and higher mindfulness.

 

people suffering from opioid addiction and chronic pain may have fewer cravings and less pain when adding mindfulness to the traditional methadone treatment.” – Grace Bullock

 

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

 

Baker, A. K., & Garland, E. L. (2019). Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology, 27(1), 55–63. https://doi.org/10.1037/pha0000225

 

Abstract

Prescription opioid misuse among chronic pain patients is associated with self-regulatory deficits, affective distress and opioid cue reactivity. Dispositional mindfulness has been associated with enhanced self-regulation, lower distress, and adaptive autonomic responses following drug cue exposure. We hypothesized that dispositional mindfulness might serve as a protective factor among opioid-treated chronic pain patients. We examined heart rate variability (HRV) during exposure to opioid cues and depressed mood as mediators of the association between dispositional mindfulness and opioid craving. Data were obtained from a sample of chronic pain patients (N=115) receiving long-term opioid pharmacotherapy. Participants self-reported opioid craving and depression, and HRV was measured during an opioid-cue dot probe task. Dispositional mindfulness was significantly positively correlated with HRV, and HRV was significantly inversely associated with opioid craving. Dispositional mindfulness was significantly negatively correlated with depression, and depression was significantly positively correlated with opioid craving. Path analysis revealed significant indirect effects of dispositional mindfulness on craving through both HRV and depression. Dispositional mindfulness may buffer against opioid craving among chronic pain patients prescribed opioids; this buffering effect may be a function of improved autonomic and affective responses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/