Addiction

Improve Self-Control and Emotionality with Mindfulness

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By John M. de Castro, Ph.D.

 

“I noticed that people who have addictions and those who teach mindfulness speak the same language. Mindfulness teachers will tell you that 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

 

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.  Addictions appear to act via changes to the brain systems affecting self-control; activity in the Anterior Cingulate Cortex (ACC) and adjacent medial Prefrontal Cortex (mPFC). Mindfulness training has also been shown to alter the activity of these structures in the opposite direction through a process called neuroplasticity. This makes a case that mindfulness acts to help in the treatment of addictions by altering the same structures involved in addictions.

 

In today’s Research News article “Mindfulness meditation improves emotion regulation and reduces drug abuse.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1279737795383477/?type=3&theater

or below or view the full text of the study at:

http://www.drugandalcoholdependence.com/article/S0376-8716(16)00117-4/fulltext

Tang and colleagues review a number of their studies on the relationships between mindfulness, the psychological properties of addictions, and the neural systems underlying self-control and addiction. They employed a mindfulness meditation training technique called integrative body–mind training (IBMT) and found that it improved executive function, emotions, and responsiveness to stress.

 

In other studies, they investigated the brain’s response to IBMT and found that it increased activity in the Anterior Cingulate Cortex (ACC) which is known to be involved in emotion regulation and the activity of the parasympathetic nervous system, that is known to be an antidote to stress responses. These results strongly suggest that mindfulness training (IBMT) acts in ways that would tend to counteract the effects of addictions including self-control and stress responsiveness. Tang and colleagues went on to test IBMT on students who were addicted to cigarettes (nicotine). They found that smokers had lower activity in Anterior Cingulate Cortex (ACC) and the medial Prefrontal Cortex (mPFC). But, IBMT training significantly reduced cigarette smoking and increased both ACC and mPFC activity.

 

These results suggest that mindfulness meditation increases activity in ACC and mPFC which are involved in emotion regulation and self-control. The improvements in these areas, in turn, assist in the prevention and treatment of addictions. These studies have produced an integrated theory of how mindfulness effects addiction by altering the nervous system in such a way as to counteract the psychological issues that underlie addictions. These studies are leading to a better understanding of how mindfulness training produces improvements in addictions.

 

So, improve self-control and emotionality with mindfulness and reduce addictions.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise. With so much opportunity for practice—rather than, say, only practicing when someone offers them a cigarette—people can learn that skill deeply.” –  James Davis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Tang YY, Tang R, Posner MI. Mindfulness meditation improves emotion regulation and reduces drug abuse. Drug Alcohol Depend. 2016 Jun 1;163 Suppl 1:S13-8. doi: 10.1016/j.drugalcdep.2015.11.041

 

Highlights

  • We review the effects of mindfulness meditation on emotion regulation and addiction.
  • We propose the brain mechanism of mindfulness meditation.
  • We examine addiction treatment using mindfulness meditation.

Abstract

BACKGROUND: The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activity in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such asmindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction.

METHODS: In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control.

RESULTS: In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training.

CONCLUSIONS: These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment.

http://www.drugandalcoholdependence.com/article/S0376-8716(16)00117-4/fulltext

 

 

Improve Thought Process in Addiction Recovery with Mindfulness

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By John M. de Castro, Ph.D.

 

“First of all, 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. This is due to your learning to deal with uncomfortable feelings that might accompany modified behaviors, rather than reacting on automatic pilot. 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.” – Rachel Fintzy

 

We typically think of drug abuse as being focused on a single substance, e.g. cocaine, alcohol, opiates, etc. Many addicts, however, abuse multiple drugs, obtaining whatever is least expensive and most easily available. Some addicts combine drugs to produce a more intense high. This is called polysubstance abuse and is defined as the use at least three different classes of addictive substances over a 12-month period, without forming a preference for any single drug that qualifies for dependence on its own. Polysubstance abuse is often accompanied with significant psychological problems and it is associated with impairments in thought processes (executive functions).

 

Illicit drug use is quite common with an estimated 24.6 million Americans aged 12 or older—9.4 percent of the population—having used an illicit drug in the past month. It is increasing as over the last 10 years it has increased from 8.3%. It is estimated that around 42% of substance abusers are polysubstance abusers. So, polysubstance abuse is a major problem affecting around 4% of the U.S. population.

 

Mindfulness training has been shown to be effective in treatment for substance abuse, helping to reduce relapse. Recently, a combination of goal management and mindfulness training has been shown to be helpful in recovery from polysubstance abuse. In today’s Research News article “Goal Management Training and Mindfulness Meditation improves executive functions and transfers to ecological tasks of daily life in polysubstance users enrolled in therapeutic community treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1271975576159699/?type=3&theater

or below, Valls-Serrano and colleagues delved a little deeper into the effects of this combined treatment on the thought processes (executive function) of polysubstance abusers. They recruited polysubstance abusers and randomly assigned them to receive the combination of goal management and mindfulness meditation training or to a treatment as usual control condition. Treatment occurred over 8 weeks with one goal management and one mindfulness meditation training session per week. Measurements were taken before and after treatment of perceived stress and a series of “laboratory tasks of basic and complex executive functions (i.e., basic: working memory and inhibition; complex: planning and self-regulation) and in an ecological task of goal-directed behavior.”

 

They found that the combined training produced a significant reduction in perceived stress and improvements in executive functions, including working memory, reflection/impulsivity decision making, and real world planning. The reduction in stress would be expected as mindfulness training has been repeatedly demonstrated to reduce the psychological and physiological responses to stress. Mindfulness training has also been shown to improve memory and cognitive function and reduce impulsivity. The importance of the present study is to demonstrate that these improvements occur with polysubstance abusers in treatment. This suggests that the treatment improves their thinking and planning ability. Importantly, improvements in these areas, particularly in working memory and impulsivity, have been shown to be highly related to successful abstinence from drugs.

 

These are encouraging results and suggest that polysubstance abuse is amenable to treatment with a combination of goal management and mindfulness meditation training which improves both executive function and perceived stress, which in turn improves the likelihood of successful treatment outcomes.

 

So, improve thought process in addiction recovery with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“There’s a shift in the individual’s relationship to discomfort. Let’s say someone is feeling depressed, or sad, lonely or bored — something that tends to trigger craving and then substance use. These practices are teaching people to notice that arising, and to relate to that differently.“ –  Sarah Bowen

 

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

 

Study Summary

Valls-Serrano C, Caracuel A, Verdejo-Garcia A. Goal Management Training and Mindfulness Meditation improves executive functions and transfers to ecological tasks of daily life in polysubstance users enrolled in therapeutic community treatment. Drug Alcohol Depend. 2016 May 20. pii: S0376-8716(16)30115-6. doi: 10.1016/j.drugalcdep.2016.04.040. [Epub ahead of print]

 

Highlights

  • Goal Management Training + MindfulnessMeditationimproves working memory and reflection-impulsivity in polysubstance users in therapeutic community treatment.
  • Executive functiongains transfer to daily activities measured by an ecological task.
  • The training was also associated with reduction of stress levels.

Abstract

BACKGROUND: We have previously shown that Goal Management Training+Mindfulness Meditation (GMT+MM) improves executive functions in polysubstance users enrolled in outpatient treatment. The aim of this study was to establish if GMT+MM has similar positive effects on executive functions in polysubstance users in residential treatment, and if executive functions’ gains transfer to more ecologically valid goal-oriented tasks.

METHODS: Thirty-two polysbustance users were randomly allocated to eight weeks of GMT+MM (n=16) or control, i.e., no-intervention (n=16); both groups received treatment as usual. Outcome measures included performance in laboratory tasks of basic and complex executive functions (i.e., basic: working memory and inhibition; complex: planning and self-regulation) and in an ecological task of goal-directed behavior (the Multiple Errands Test – contextualized version, MET-CV) measured post-interventions.

RESULTS: Results showed that GMT+MM was superior to control in improving basic measures of working memory (Letter-number sequencing; F=4.516, p=0.049) and reflection impulsivity (Information Sampling Test; F=6.217, p=0.018), along with initial thinking times during planning (Zoo Map Test; F=8.143, p=0.008). In addition, GMT+MM was superior to control in improving performance in the MET-CV (task failures; F=8.485, p=0.007).

CONCLUSION: Our findings demonstrate that GMT+MM increases reflective processes and the achievement of goals in daily activities, furthermore ecological test can detects changes easily than laboratory tasks.

http://www.sciencedirect.com.ezproxy.shsu.edu/science/article/pii/S0376871616301156

 

Reduce Maladaptive Ideas in Substance Abuse with Mindfulness

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Reduce Maladaptive Ideas in Substance Abuse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise. With so much opportunity for practice—rather than, say, only practicing when someone offers them a cigarette—people can learn that skill deeply.” – James Davis

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually and including all causes alcohol abuse accounts for around 90,000 deaths each year, making it the third leading preventable cause of death in the United States.

 

Obviously there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse.

 

The fact that mindfulness training works in reducing relapse implies that there are alterations in mental contents and thought processes that may be making relapse more likely. It has been found that addicts frequently have maladaptive conceptualizations of themselves and the environment called maladaptive schemas. These have been defined as a “broad, pervasive theme or pattern comprised of memories, emotions, cognitions, and bodily sensations regarding oneself and one’s relationships with others … [that] are dysfunctional to a certain degree.” Eighteen different schemas have been identified; emotional deprivation, abandonment, mistrust/abuse, social isolation, defectiveness, failure, dependence, vulnerability, enmeshment, subjugation, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, insufficient self-control, approval-seeking, negativity/pessimism, and punitiveness.

 

In today’s Research News article “The Relation between Trait Mindfulness and Early Maladaptive Schemas in Men Seeking Substance Use Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1233666469990610/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465817/

Shorey and colleagues investigate the degree to which mindfulness is related to these maladaptive schemas in men seeking substance abuse treatment. They found that the higher the level of mindfulness the lower the levels of maladaptive schemas. This was true in general but only 15 of the 18 schemas reached statistical significance. They also found that addicts who endorsed more than one maladaptive schema were significantly lower in mindfulness than those who endorsed one or less.

 

These results are interesting, but, it should be kept in mind that the study was correlational and mindfulness was not manipulated. So, a causal connection cannot be demonstrated. It is equally likely that mindfulness causes lower schemas, that lower schemas cause mindfulness, or that some third variable, e.g. the intensity of addiction, causes both. It remains for future research to determine if mindfulness training can produce changes in these maladaptive schemas.

 

Keeping this in mind, the results suggest that maladaptive ways of thinking are associated with addiction and that mindfulness training may be a solution, reducing the schemas and thereby assisting in relapse prevention.

 

So, reduce maladaptive ideas in substance abuse with mindfulness.

 

“Teaching clients “awareness in the moment” can help them develop healthy responses to stress and cravings. This attitude of curiosity and openness to inner life can also enrich their entire sobriety.” – Jenifer Talley

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Shorey, R. C., Brasfield, H., Anderson, S., & Stuart, G. L. (2015). The Relation between Trait Mindfulness and Early Maladaptive Schemas in Men Seeking Substance Use Treatment. Mindfulness, 6(2), 348–355. http://doi.org/10.1007/s12671-013-0268-9

 

Abstract

Recent research has examined the relation between mindfulness and substance use, demonstrating that lower trait mindfulness is associated with increased substance use, and that mindfulness-based interventions help to reduce substance use. Research has also demonstrated that early maladaptive schemas are prevalent among individuals seeking substance use treatment and that targeting early maladaptive schemas in treatment may improve outcomes. However, no known research has examined the relation between mindfulness and early maladaptive schemas despite theoretical and empirical reasons to suspect their association. Therefore, the current study examined the relation between trait mindfulness and early maladaptive schemas among adult men seeking residential substance abuse treatment (N = 82). Findings demonstrated strong negative associations between trait mindfulness and 15 of the 18 early maladaptive schemas. Moreover, men endorsing multiple early maladaptive schemas reported lower trait mindfulness than men with fewer early maladaptive schemas. The implications of these findings for future research and treatment are discussed.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465817/

Kick the Smoking Habit with Mindfulness

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Kick the Smoking Habit with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There’s lots of self-judgment that goes on when you’re trying to do something difficult, like trying to quit smoking. Also if we judge others, that can get us riled up, which can lead to smoking. We teach it as a way to learn to concentrate more but also to let go of judgment. When people have a craving, they can notice if they’re resisting or beating themselves up.” – 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).

 

Nicotine is one of the most addictive substances known. But, its addictiveness is not just due to its pharmacological properties. Addiction to smoking also involves learned or conditioned factors, genetics, and social and environmental factors. This makes it easy to become addicted and very difficult to stop. To some extent this is why there still are high rates of smoking even though mostly everyone understands that it has very negative effects on health and longevity.

 

There are a wide variety of methods and strategies to quit smoking which are to some 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 after quitting if a single cigarette is smoked, going back to regular smoking is almost assured. As John Polito wrote “nicotine dependency recovery is one of the few challenges in life where being 99% successful all but assures 100% defeat.”

 

So, better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness training has been shown to be helpful in treatment for addiction and prevention of relapse after recovery. In today’s Research News article “Mindfulness training for smoking cessation: A meta-analysis of randomized-controlled trials.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1224395630917694/?type=3&theater

or below

Oikonomou and colleagues review the published randomized controlled trials on the use of mindfulness training as a treatment for quitting cigarette smoking. They found, not surprising, that the training was successful in increasing mindfulness. More importantly, they found that although mindfulness training did not produce significantly different cigarette abstinence rates at 4 to 6 weeks following training, it did at 17 to 24 weeks, where 25.2% of mindfulness trained participants were abstinent while only 13.6% of usual treatment participants were.

 

These results are encouraging as the reviewed studies were high quality, well controlled, and designed trials. They suggest that mindfulness training is effective in promoting the long-term cessation of cigarette smoking. It is not known exactly what it is about mindfulness training that assists with cessation of smoking. But, it can be speculated that since quitting smoking is very stressful, mindfulness training might help because it reduces the psychological and physical responses to stress, thus making it easier for the individual to withstand the stress of nicotine withdrawal. The fact, however, that mindfulness training did not improve cessation rates at 4 weeks after treatment and it is during this time that nicotine withdrawal effects are present, that it is unlikely that this is the mechanism of action.

 

Staying abstinent from smoking over the long-term requires that the individual be able to refrain from responding to the myriad of social, environmental, and physical triggers that signal cigarette smoking. By increasing mindfulness, the training may make it easier for the individual to be aware of these triggers and thus be better able to prevent responding to them. Regardless of the mechanism, it is clear that mindfulness training is effective in promoting abstinence from cigarette smoking following successful quitting. This is an important advance in the fight against this major threat to health.

 

So, kick the smoking habit with mindfulness.

 

“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

 

 

Study Summary

Oikonomou MT, Arvanitis M, Sokolove RL. Mindfulness training for smoking cessation: A meta-analysis of randomized-controlled trials. J Health Psychol. 2016 Apr 4. pii: 1359105316637667. [Epub ahead of print]

 

Abstract

Recent studies have shown that mindfulness training has a promising potential for smoking treatment. In order to examine the efficacy of mindfulness training in smoking cessation, we performed a systematic review of the literature and meta-analysis of randomized controlled trials. Four randomized controlled trials with 474 patients were included in our analysis. The results showed that 25.2 percent of participants remained abstinent for more than 4 months in the mindfulness group compared to 13.6 percent of those who received usual care therapy (relative risk, 1.88; 95 percent confidence interval, 1.04–3.40). Our results suggest that mindfulness training may have an important role to play in efforts to lower cigarette smoking rates.

 

Non-judging Mindfulness Facilitates Quitting Smoking

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By John M. de Castro, Ph.D.

 

“smoking is a form of insanity that the logical mind and our own better judgment cannot solve. Many smokers have been helped by mindfulness meditation, a means of slowing down the action and beginning to penetrate the experience of the addiction. Once it is better understood, a rational choice can be made (of whether to continue smoking or not).” – Lawrence Peltz

 

“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).

 

Nicotine is one of the most addictive substances known. But, its addictiveness is not just due to its pharmacological properties. Addiction to smoking also involves learned or conditioned factors, genetics, and social and environmental factors. This makes it easy to become addicted and very difficult to stop. To some extent this is why there still are high rates of smoking even though mostly everyone understands that it has very negative effects on health and longevity.

 

There are a wide variety of methods and strategies to quit smoking which are to some 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 after quitting if a single cigarette is smoked, going back to regular smoking is almost assured. As John Polito wrote “nicotine dependency recovery is one of the few challenges in life where being 99% successful all but assures 100% defeat.”

 

So, 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 what aspects of mindfulness are responsible for the beneficial effects. In today’s Research News article “Nonjudging Facet of Mindfulness Predicts Enhanced Smoking Cessation in Hispanics.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1221811314509459/?type=3&theater

or below or view the full text of the study at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641832/

Spears and colleagues recruited current smokers and measured the Five Facets of Mindfulness Scale (FFMQ). They then applied a quitting smoking treatment program “including nicotine patch therapy, self-help materials, and six brief in-person and telephone counseling sessions.”

 

The FFMQ measures observing, describing, acting with awareness, non-judging, and non-reactivity facets of mindfulness. They found that the non-judging was the sole facet of mindfulness that predicted successful abstinence from smoking. It significantly predicted abstinence even when its relationship with reduced depression and with demographic variables were accounted for. Of the participants who were high in non-judging 54% were abstinent from smoking 3 weeks after the end of treatment versus 23% of those low in non-judging, while a half year after treatment ceased 23% versus 5% of high versus low non-judging participants were still abstinent. Although 23% success after 6 months may seem low, relative to other programs with about a 5% success rate and low non-judging participants, also with a 5% success rate, the results for high non-judging participants are quite high.

 

The results clearly demonstrate that non-judging is importantly related to successful smoking cessation and continued abstinence. Non-judging involves being aware of thoughts and feelings but accepting them and not placing value judgements on them. This skill may be helpful in remaining abstinent from smoking as it allows the individual to recognize their thoughts about cigarettes and their cravings simply as they are and not as an indicator that they are failing, that they are weak, or that they shouldn’t be feeling this way. That acceptance may go a long way to helping the individual cope with the cravings and successfully restrain themselves from acting on them and return to smoking. The individuals don’t deny how they’re feeling and accept their feelings, allowing them to better cope with the feelings and remain abstinent.

 

It should be noted that these results were correlational, not manipulating mindfulness, just simply measuring the levels present. As a result it can’t be concluded that non-judging is the cause of great success in smoking cessation. It could well be that there is something else about the individual that both makes them non-judging and better at quitting. It remains for future studies to manipulate non-judging facet of mindfulness and determine if it produces greater success. Regardless, is an interesting and potentially important observation that could lead to better treatments for quitting 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.” – Dr. Nora Volkow

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Spears, C. A., Houchins, S. C., Stewart, D. W., Chen, M., Correa-Fernández, V., Cano, M. Á., … Wetter, D. W. (2015). Nonjudging Facet of Mindfulness Predicts Enhanced Smoking Cessation in Hispanics. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors,29(4), 918–923. http://doi.org/10.1037/adb0000087

 

Abstract

Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, non-judgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age=39, 77.9% ≤ high school education) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 post-quit (biochemically-confirmed and determined using an intent-to-treat approach). Logistic random coefficients regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting with Awareness, Nonjudging, Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks post-quit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness.

 

Kick Opioid Dependence with Mindfulness

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Kick Opioid Dependence with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Ultimately, mindfulness drives at the root of compulsive behaviors by undermining the assumption that inner experience is intolerable and therefore requires immediate relief through substance use.” – Jennifer Talley

 

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. The number of prescriptions for opioids (like hydrocodone and oxycodone products) have increased from around 76 million in 1991 to nearly 207 million in 2013. This creates a major problem because of the strong addictive qualities of opioids. As a result, opioid addiction has become epidemic in the United States. It is estimated that over 2 million Americans abuse or are addicted on opioid painkillers. These addictions have stark economic costs. It is estimated that the abuse of prescription opioids costs around $60 billion a year, with 46% attributable to workplace costs (e.g., lost productivity), 45% to healthcare costs (e.g., abuse treatment), and 9% to criminal justice costs.

 

Opioid abuse, however produces even worse consequences than those created by addiction. It is 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. It would help if doctors were more judicious in prescribing opioids. But, there will still be a need to assist those who abuse or become addicted.

 

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. Recent research is indicating that mindfulness and also spirituality can be quite helpful for kicking the habit. Mindfulness-Based Relapse Prevention (MBRP) was specifically developed to employ mindfulness training along with other proven methods to assist addicts in remaining off of drugs.

 

In today’s Research News article “Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1214040818619842/?type=3&theater

See below, or for full text see:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749687/

Imani and colleagues randomly assigned opioid addicts to either treatment as usual or an 8-week Mindfulness-Based Relapse Prevention (MBRP) program delivered in a group setting. They found that compared to before treatment, MBRP significantly increased mindfulness and produced a significantly greater decrease in both opioid and alcohol consumption than the usual treatment alone. These are excellent results. Firstly, because the treatment could be delivered in a group format increasing efficiency and reducing costs. But, most importantly, MBRP added to the usual treatment, improved effectiveness. By combining the two, a more potent treatment program is produced.

 

How mindfulness helps with relapse prevention is not known. But it can be speculated that mindfulness improves emotion regulation making it easier for the addict to respond appropriately to an emotion rather than needing to self-medicate with an opioid. It is also known that mindfulness reduces the physiological and psychological responses to stress, making it easier for the addict to cope with stress and thereby reducing the need to cope by taking opioids. Regardless of the explanation it is clear that mindfulness is an important contributor to preventing relapse with opioids.

 

So, kick opioid dependence with mindfulness.

 

“The power of mindfulness is incredible. The simple meditation technique has the power to ease pain in arthritis and asthma patients, reduce anxiety and symptoms of depression, and improve heart health. It so powerful that it works better than conventional methods (medication, psychotherapy) for many of these conditions. And now, a new study finds that it can bring back happiness in people falling down the rabbit hole of opioid drug addiction.” – Anthony Rivas

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Imani, S., Atef Vahid, M. K., Gharraee, B., Noroozi, A., Habibi, M., & Bowen, S. (2015). Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment. Iranian Journal of Psychiatry, 10(3), 175–184.

 

Abstract

Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.

Methods: The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments.

Results: The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group.

Conclusion: The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749687/

Improve Drug and Alcohol Relapse Prevention with Mindfulness

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By John M. de Castro, Ph.D.

 

“it’s tempting to conclude that mindfulness is the “best new thing” for addiction treatment, but that in reality, further study is needed. It absolutely has promise, we have a lot more to learn, this is the beginning.” – Sarah Bowen

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually and including all causes alcohol abuse accounts for around 90,000 deaths each year, making it the third leading preventable cause of death in the United States.

 

Obviously there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses.

 

Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015

 

An important treatment component that may contribute to the effectiveness of MBRP is that it be practiced at home. The program recommends that meditation be practiced for 45 minutes a day. Yet, there has been no systematic research concerning compliance with home practice and its effects on the efficacy of treatment. In today’s Research News article “Enactment of Home Practice Following Mindfulness-based Relapse Prevention and its Association with Substance-use Outcomes”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1182260555131202/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260625/

Grow and colleagues recruited adults with substance abuse disorders who had successfully completed withdrawal and a therapeutic program randomly and were in remission. “Primary substances of abuse were alcohol (45.2%), cocaine/crack (36.2%), methamphetamines (13.7%), opiates/heroin (7.1%), marijuana (5.4%), and other (1.9%).” They were assigned to either a Mindfulness-based Relapse Prevention (MBRP) program or a standard aftercare program. The MBRP program consisted of 8 weekly 2-hour closed small group (6-11) sessions.

 

They found that MBRP participants engaged in home practice that peaked immediately after treatment and declined slightly 2 to 4-months post-treatment. Importantly the amount of home practice was significantly inversely related to cravings for drugs and the frequency of drug use post-treatment. In other words, the more the participant practiced at home the less they craved drugs and the less they used them. This underscores the potential importance of home practice.

 

It is important to note that the results do not demonstrate that engagement in home practice caused less craving and drug use as these results were correlative. It is possible that less craving and less drug use caused more home practice or that some third factor such as the degree of addiction was responsible for both. Regardless the present results indicate that there needs for closer study of what transpires outside of the treatment sessions as potential influences on the success of treatment.

 

So, improve drug and alcohol relapse prevention with mindfulness.

 

“If there is no opportunity to use then there is no internal struggle. It is this internal struggle that feeds the cravings. Trying to fight cravings is like trying to block a waterfall. We end up being inundated. With the approach of mindfulness, we step aside and watch the water (cravings, impulses & urges) just go right past.” – Chris Walsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Stop Self-Medicating with Opioids with Mindfulness

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By John M. de Castro, Ph.D.

 

 

 “The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies.  It is estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.  The consequences of this abuse have been devastating and are on the rise.” – Nora D. Volkow

 

The over prescription of opioid painkillers in the United States has become a major problem. The number of prescriptions for opioids (like hydrocodone and oxycodone products) have increased from around 76 million in 1991 to nearly 207 million in 2013. This creates a major problem because of the strong addictive qualities of opioids. As a result, opioid addiction has become epidemic in the United States. It is estimated that over 2 million Americans abuse or are addicted on opioid painkillers. These addictions have stark economic costs. It is estimated that the abuse of prescription opioids costs around $60 billion a year, with 46% attributable to workplace costs (e.g., lost productivity), 45% to healthcare costs (e.g., abuse treatment), and 9% to criminal justice costs.

 

Opioid abuse, however produces even worse consequences than those created by addiction. It is 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. It would help if doctors were more judicious in prescribing opioids. But, there will still be a need to assist those who abuse or become addicted.

 

It appears that to some extent opioid abuse occurs from a desire to escape from negative emotions. The abuser then self-medicates with opioids to help them feel better. Hence, it may be helpful to better understand this self-medication to better design treatments for abuse and addiction. Mindfulness training has been shown to be helpful in recovering from addictions. So, it would seem reasonable to investigate the relationship of mindfulness to self-medication. In today’s Research News article “Low Dispositional Mindfulness Predicts Self-Medication of Negative Emotion with Prescription Opioids”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1176972385660019/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310788/

Garland and colleagues examined the characteristics, including mindfulness and self-medication, of opioid abusers who were seeking treatment. Remarkably they found that 95% of the abusers reported using opioids to self-medicate from the negative emotions of anxiety, fear, depression, sadness, anger, or frustration. Importantly, the higher the abuser was in mindfulness the lower the use of opioids for self-medication from negative emotions.

 

These findings suggest that mindfulness may be an antidote for self-medication use of opioids for the relief of negative emotional states. But, we cannot jump to this conclusion as the study was observational and did not manipulate mindfulness. So, mindfulness may lower self-medication, or self-medication may lower mindfulness, or some third factor such as intensity of addiction may be related to both. It will require further research to determine causation.

 

One of the key effects of mindfulness is that it appears to heighten emotion regulation. The individual then experiences the emotions fully, doesn’t suppress them, but is able to respond to them appropriately and adaptively. So, when experiencing negative emotions, a highly mindful person would be able to respond appropriately and not try to escape them with opioids.

 

Regardless of the explanation it is clear that when mindfulness is high, self-medication with opioids is low. So, stop self-medicating with opioids with mindfulness.

 

“We can teach people to use mindfulness to appreciate and enjoy life more, and by doing that, they may feel less of a need for addictive drugs.” – Eric Garland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Lower Aggression with Mindfulness

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“There is no life to be found in violence. Every act of violence brings us closer to death. Whether it’s the mundane violence we do to our bodies by overeating toxic food or drink or the extreme violence of child abuse, domestic warfare, life-threatening poverty, addiction, or state terrorism.” – bell hooks
Aggression and violence are highly linked to substance abuse particularly alcohol. It is estimated that the proportion of violent offenders who are likely to be drinking at the time of the offense is up to 86 percent for homicide offenders, 37 percent for assault offenders, 60 percent for sexual offenders, up to 57 percent of men and 27 percent of women involved in marital violence, and 13 percent of child abusers. This relationship appears to have a causal connection to the effect of these substances on the nervous system with many drugs of abuse affecting the brain in such a way as to release aggressive tendencies. Obviously, there is a need to find methods to help deal with aggressive tendencies in substance abusers.

 

Mindfulness has been shown to be helpful in the treatment of substance abuse and for relapse prevention (see http://contemplative-studies.org/wp/index.php/category/research-news/addiction/). It is also know to assist with emotion regulation and anger management (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/). So, it would seem reasonable to believe that mindfulness may be related to aggressive behavior in substance abusers.  In today’s Research News article “Dispositional Mindfulness and Aggression Among Women in Residential Substance Use Treatment”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1152725344751390/?type=3&theater

Shorey and colleagues investigated the relationship between mindfulness and aggression in women who were undergoing residential substance abuse treatment. They found that the higher the level of mindfulness the lower the levels of aggression in the women, including verbal aggression, physical aggression, and aggressive attitude.

 

It should be noted that these results were correlational in nature and as such causation cannot be determined. It is possible that high mindfulness lowers aggressiveness, or that low aggressiveness causes increased mindfulness, or that some other factor is related to both. It will require an active controlled test perhaps including mindfulness training to determine if mindfulness may be a useful treatment for aggression in substance abusers.

 

Nevertheless, it would appear that there is a negative, inverse, relationship between mindfulness and aggression in women in substance abuse treatment. There are a number of possible explanations for the relationship. Since mindfulness improves emotion regulation it may assist the women in reacting in a controlled and appropriate manner when anger and frustration arises rather than evoking aggressive behavior. Also, since mindfulness is known to reduce the physiological and psychological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/) and attempting to control an addiction is stressful, it is possible that mindful women may be better at coping with stress rather than lashing out aggressively. Finally, since mindfulness appears to improve the response to substance abuse treatment it is possible that an improved ability to control urges for substances relaxes the women making them less aggressive.

 

Regardless of the explanation, the results suggest that mindfulness is associated with lower aggression.

 

“The most fundamental aggression to ourselves, the most fundamental harm we can do to ourselves, is to remain ignorant by not having the courage and the respect to look at ourselves honestly and gently.” – Pema Chodran

 

CMCS – Center for Mindfulness and Contemplative Studies

Spirituality Assists in Addiction Recovery

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“Addiction tries to make a spiritual experience static. When we are in an addictive process, we want to hold on to the moment, not feeling the discomfort of the longing but attempting to maintain what we feel in an instant. Our spirituality becomes stagnate and the addiction leads us into a deep bondage with a substance or process.” –  Jim Seckman

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually and including all causes alcohol abuse accounts for around 90,000 deaths each year, making it the third leading preventable cause of death in the United States.

 

Drug and alcohol addictions are very difficult to kick and if successful about half the time the individual will relapse. So, there have been developed a number of programs to help the addict recover and prevent relapse. The 12 step programs of Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, etc. have been as successful as any programs in treating addictions. These programs insist that spirituality is essential to recovery.  Indeed, addiction is described as a “spiritual, physical, and emotional” problem. It appears that spirituality is highly associated with successful treatment and relapse preventions as demonstrated in a number of research studies (see links below).

 

In today’s Research News article “NIDA-Drug Addiction Treatment Outcome Study (DATOS) Relapse as a Function of Spirituality/Religiosity”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1146018118755446/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455957/

Schoenthaler and colleagues analyze the data from the National Institutes of Drug Abuse (NIDA) Drug Addiction Treatment Outcome Study. They found that there were much higher rates of successful treatment outcomes for drug abuse when either spirituality or religious participation were high in the patients. They found that the higher the level of spirituality or religious participation the greater the likelihood that the individual will be drug free 12 months after the end of the program. This was true for alcohol, cocaine, heroin, and marijuana addictions, but not for crack cocaine addiction. The measures of spirituality and religious participation that were most clearly linked to successful outcomes were frequency of attending religious services, reading religious books watching religious programs and meditation/prayer

 

It should be pointed out that as impressive as these results are, they do not prove that spirituality and religious participation were the cause of improved addiction recovery. There was not a manipulation so there may be other factors that both increase addiction recovery and simultaneously spirituality and religious participation. These could include the support of a religious community, or that people who tend toward spirituality and religious participation are also good candidates for addiction recovery, or the belief that spirituality and religious participation would help.

 

Why is spirituality and religious participation associated with better outcomes? One possible reason is that spirituality provides a source of comfort as the individual faces the challenges of recovery. Spirituality may provide another way to cope with the individual’s problems. The individual can take solace in the Devine instead of drugs when upheavals occur. This can help to break the vicious cycle, making it possible to deal with the addiction. Spirituality and religious participation can provide the recognition that help is needed, that they can’t control the addiction without outside assistance. The addict then can allow fellow addicts, people close to them, or therapists to provide needed assistance when the urge to use the drug begins to overwhelm the individual’s will to stop. The recognition that there are greater powers than themselves makes it easier to ask for and accept assistance.

 

It has also the case that spirituality is associated with negative beliefs about drugs. Buddhism teaches that intoxication is an impediment to spiritual development. Other religions completely prohibit alcohol and drugs while many decry the behaviors that occur during alcoholic or drug induced stupor.  This provides a cognitive incompatibility between drug use and spirituality. The recognition that using drugs or alcohol is not an OK thing to do might provide the extra motivation to help withstand the cravings. In addition, spiritual groups tend to be populated with non-addicts. So, increased spirituality also tends to shift the individual’s social network away from drug or alcohol using buddies to people less inclined to provide temptation. It is very difficult to stop using when those around you are not only using themselves but encouraging you. So shifting social groups to people who abstain can help tremendously.

 

Nevertheless, it is clear that there is a strong relationship between spirituality and religious participation and successful recovery from addiction to a variety of different substances.

 

“The earliest A.A. members, then, discovered that some kind of spirituality— some kind of sense of the reality of some “beyond”—was essential to their sobriety” – Ernest Kurtz
CMCS – Center for Mindfulness and Contemplative Studies