Drugs

Help Withdraw from Antidepressant Drugs with Mindfulness

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Help Withdraw from Antidepressant Drugs with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can help you deal with emotional symptoms of SSRI withdrawal. Techniques such as meditation and deep breathing can help you reduce levels of irritability by reminding you to slow down and step back from a situation before you react.” – Sarah Fader

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

It seems reasonable to use antidepressant drugs initially in the treatment of depression but then withdraw the drugs. But withdrawal effects can occur. Symptoms of antidepressant withdrawal are anxiety, insomnia or vivid dreams, headaches, dizziness, tiredness, irritability, flu-like symptoms, including achy muscles and chills, nausea, electric shock sensations, return of depression symptoms. Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. And can help with antidepressant withdrawal.

 

Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT has been found to be effective in treating depression. Hence, there is a need to study the application of MBCT to assist in the withdrawal of antidepressant medication.

 

In today’s Research News article “Managing Antidepressant Discontinuation: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342590/), Maund and colleagues review and summarize the published research studies of the effectiveness of various therapies including Mindfulness-Based Cognitive Therapy (MBCT) to assist in the withdrawal of patients from antidepressants. They found 15 published randomized controlled trials with 3 employing MBCT.

 

They report that the randomized controlled trials found that tapering off antidepressant drugs was far more successful than abrupt withdrawal and that psychological therapies significantly assisted in the success of the process, with successful cessation rates of 40% to 95% compared to 6% to 7% when the physician sent a letter recommending withdrawal. Mindfulness-Based Cognitive Therapy (MBCT) was found to have successful cessation rates of 55% to 75%. MBCT also did not increase relapse/recurrence rates with 44% to 48% relapse.

 

There were only three randomized controlled trials that employed Mindfulness-Based Cognitive Therapy (MBCT) to aid in antidepressant withdrawal and there were no studies that included discontinuation symptoms. So, conclusions must be tempered and measured. But the published research suggests that MBCT is is safe and effective in improving the likelihood of successful withdrawal from antidepressants without increasing the likelihood of relapse.

 

So, help withdraw from antidepressant drugs with mindfulness.

 

“Psychiatric medication is designed to alleviate suffering. Mindfulness can function in this way too. However, psychiatric medication is not generally designed to promote flourishing. . . . Mindfulness can alleviate distress, but it can also lead us states of flourishing and a sense of the deep completeness of the moment.” – Matthew Brensilver

 

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

 

Maund, E., Stuart, B., Moore, M., Dowrick, C., Geraghty, A., Dawson, S., & Kendrick, T. (2019). Managing Antidepressant Discontinuation: A Systematic Review. Annals of family medicine, 17(1), 52–60. doi:10.1370/afm.2336

 

Abstract

PURPOSE

We aimed to determine the effectiveness of interventions to manage antidepressant discontinuation, and the outcomes for patients.

METHODS

We conducted a systematic review with narrative synthesis and meta-analysis of studies published to March 2017. Studies were eligible for inclusion if they were randomized controlled trials, quasi-experimental studies, or observational studies assessing interventions to facilitate discontinuation of antidepressants for depression in adults. Our primary outcomes were antidepressant discontinuation and discontinuation symptoms. Secondary outcomes were relapse/recurrence; quality of life; antidepressant reduction; and sexual, social, and occupational function.

RESULTS

Of 15 included studies, 12 studies (8 randomized controlled trials, 2 single-arm trials, 2 retrospective cohort studies) were included in the synthesis. None were rated as having high risk for selection or detection bias. Two studies prompting primary care clinician discontinuation with antidepressant tapering guidance found 6% and 7% of patients discontinued, vs 8% for usual care. Six studies of psychological or psychiatric treatment plus tapering reported cessation rates of 40% to 95%. Two studies reported a higher risk of discontinuation symptoms with abrupt termination. At 2 years, risk of relapse/recurrence was lower with cognitive behavioral therapy plus taper vs clinical management plus taper (15% to 25% vs 35% to 80%: risk ratio = 0.34; 95% CI, 0.18–0.67; 2 studies). Relapse/recurrence rates were similar for mindfulness-based cognitive therapy with tapering and maintenance antidepressants (44% to 48% vs 47% to 60%; 2 studies).

CONCLUSIONS

Cognitive behavioral therapy or mindfulness-based cognitive therapy can help patients discontinue antidepressants without increasing the risk of relapse/recurrence, but are resource intensive. More scalable interventions incorporating psychological support are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342590/

 

Improve the Psychological Health of Cancer Patients with Psilocybin

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Improve the Psychological Health of Cancer Patients with Psilocybin

 

By John M. de Castro, Ph.D.

 

“Our research has shown that, in a medically controlled setting with expert screening and preparation, psilocybin can relieve the symptoms of anxiety and depression often found in patients with a cancer diagnosis.” – Heffter Research Institute

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings. They report a loss of the personal self. They experience what they used to refer to as the self as just a part of an integrated whole. They report feeling interconnected with everything else in a sense of oneness with all things. They experience a feeling of timelessness where time seems to stop and everything is taking place in a single present moment. They experience ineffability, being unable to express in words what they are experiencing and as a result sometimes producing paradoxical statements. And they experience a positive mood, with renewed energy and enthusiasm.

 

It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.

 

Psilocybin is a psychedelic substance that is found naturally in a number of varieties of mushrooms. It has been used for centuries particularly by Native Americans for their spiritual practices. When studied in the laboratory under double blind conditions, Psilocybin has been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).”

 

In today’s Research News article “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/), Griffiths and colleagues recruited patients with a potentially life threatening cancer diagnosis and high levels of anxiety and/or a mood disorder. They were randomly assigned to receive psilocybin in the lab in a living room type highly supportive environment with either a low dose in the first session and the high dose in the second 5 weeks later or in reverse order with the high dose first followed by low dose. Doses were administered double blind.

 

They were measured during the session for heart rate and respiration and ratings by attending monitors. After the drug effects subsided (7 hours after administration) they were measured for hallucinogen ratings, altered states of consciousness, mystical experiences, states of consciousness, and mysticism. They were also measured at baseline and five weeks after each session and 6 months later for anxiety, depression, mood, psychiatric symptoms, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, life coherence, and persisting effects of psilocybin. Family friends, and co-workers were also asked to rate the participant’s behavior and attitudes.

 

After the sessions no continuing adverse events were detected. During the sessions there were significant dose dependent increases in heart rate, blood pressure, joy and happiness, and visual experiences, and all ratings by the session monitors of behavior and mood. These effects all dissipated by the end of the session.

 

In comparison to baseline at all time points after psilocybin administration there were clinically significant decreases in anxiety, depression, psychiatric symptoms and significant increases in mood, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, and life coherence. Family friends, and co-workers also reported significant improvements in mood and behavior in the cancer patients. They also found that the greater the mystical experiences that the cancer patients had during the sessions the greater the levels of meaningfulness, spiritual significance, increased life satisfaction, meaningful existence, death acceptance, death transcendence, purpose in life, and coherence and the lower the levels of anxiety and depression.

 

The results suggest that psilocybin administration to patients with life threatening cancer diagnoses who also had high levels of anxiety and/or mood disturbance produced large and clinically significant improvements in their psychological and spiritual well-being. These benefits were observed by clinicians, session monitors, family, friend, and co-workers, and the patients themselves. These results are remarkable particularly due to the magnitude of the effects, the breadth of the benefits, their obviousness to all concerned, and the persistence of the effects, generally still large and significant 6 months after the session. This suggests that psilocybin treatment may be greatly beneficial to relieve the psychological suffering and the spiritual difficulties precipitated by cancer diagnosis.

 

So, improve the psychological health of cancer patients with psilocybin.

 

“a substantial majority of people suffering cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin — the active compound in hallucinogenic “magic mushrooms.” – Vanessa McMains

 

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

 

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., … Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology (Oxford, England), 30(12), 1181–1197. doi:10.1177/0269881116675513

 

Abstract

Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/

 

Spirituality Improves Health Behaviors Particularly When Coupled with Religion

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Spirituality Improves Health Behaviors Particularly When Coupled with Religion

 

By John M. de Castro, Ph.D.

 

“Spirituality is a universal phenomenon and an inherent aspect of human nature that unfolds during adolescence as the individual searches for transcendence, meaning, and purpose in life.” – Sangwon Kim

 

We tend to think that illness is produced by physical causes, disease, injury, viruses, bacteria, etc. But many health problems are behavioral problems or have their origins in maladaptive behavior. This is evident in car accident injuries that are frequently due to behaviors, such as texting while driving, driving too fast or aggressively, or driving drunk. Other problematic behaviors are cigarette smoking, alcoholism, drug use, or unprotected sex. It is well established that if patterns and habits of healthy behaviors can be established early in life, long-term health can be promoted and ill health can be prevented. Adolescence is a time when these behavioral causes of health problems usually develop.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Religiosity is also known to help with a wide range of physical and psychological problems. So, it would make sense to investigate the influence of spirituality and religiosity on the ability of adolescents to develop positive health behaviors.

 

In today’s Research News article “”I am spiritual, but not religious”: Does one without the other protect against adolescent health-risk behaviour?” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353810/), Malinakova and colleagues obtained data from a Czechoslovakian survey of a representative sample of adolescents aged 11, 13, and 15 years. Among other measures the youths completed measures of religious attendance, spirituality, tobacco, alcohol, and cannabis use, drug use experience, and sexual intercourse.

 

They found that either religious attendance or high spirituality was associated with a lower risk of smoking while only high spirituality was associated with lower alcohol use and only religious attendance appeared to be associated with lower early sexual intercourse. But when the combination of religious attendance and high spirituality was looked at, there were large significantly lower levels of tobacco, alcohol, and cannabis use and lifetime drug use.

 

These results are interesting but correlational. So, caution must be exercised in making conclusions about causality. They suggest, though, that individually religious attendance and spirituality only have limited associations with lower levels of health risk behaviors in adolescents. But in combination they have a strong association with lower levels of these behaviors. This suggests that just attending religious services doesn’t impact health risk behaviors unless it is combined with spirituality. It would appear that when youths are religious and also spiritual, they are much less likely to engage in behaviors that may damage their health.

 

So, spirituality improves health behaviors particularly when coupled with religion.

 

“The results also showed a consistent relationship between high levels of spiritual health and positive overall self-rated health. Overall, while the perceived importance of spiritual health declined by age, for adolescents who maintain a strong sense of the importance of self-perceived spiritual health, the possible benefits are striking.” – HBSC News

 

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

 

Malinakova, K., Kopcakova, J., Madarasova Geckova, A., van Dijk, J. P., Furstova, J., Kalman, M., … Reijneveld, S. A. (2019). “I am spiritual, but not religious”: Does one without the other protect against adolescent health-risk behaviour?. International journal of public health, 64(1), 115–124. doi:10.1007/s00038-018-1116-4

 

Abstract

Objectives

Spirituality and religious attendance (RA) have been suggested to protect against adolescent health-risk behaviour (HRB). The aim of this study was to explore the interrelatedness of these two concepts in a secular environment.

Methods

A nationally representative sample (n = 4566, 14.4 ± 1.1 years, 48.8% boys) of adolescents participated in the 2014 Health Behaviour in School-aged Children cross-sectional study. RA, spirituality (modified version of the Spiritual Well-Being Scale), tobacco, alcohol, cannabis and drug use and the prevalence of sexual intercourse were measured.

Results

RA and spirituality were associated with a lower chance of weekly smoking, with odds ratios (OR) 0.57 [95% confidence interval (CI) 0.36–0.88] for RA and 0.88 (0.80–0.97) for spirituality. Higher spirituality was also associated with a lower risk of weekly drinking [OR (95% CI) 0.91 (0.83–0.995)]. The multiplicative interaction of RA and spirituality was associated with less risky behaviour for four of five explored HRB. RA was not a significant mediator for the association of spirituality with HRB.

Conclusions

Our findings suggest that high spirituality only protects adolescents from HRB if combined with RA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353810/

 

Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

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Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.“ – Kelle Walsh

 

Mindfulness 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. As a result, mindfulness training has been called the third wave of therapies.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of good mental health.

 

In today’s Research News article “Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/ ), Bravo and colleagues recruited active and retired military personnel and college students. They were measured online for mindfulness, depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms.

 

They found that overall, the greater the levels of mindfulness, the better the mental health of the participants including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. The military personnel were higher on all measures except rumination than the college students.

 

For the college students latent profile analysis revealed 4 mindfulness profiles ““high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness” group (i.e., relatively low-to-average on all facets of mindfulness), a “judgmentally observing” group (i.e., high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).” For the military personnel latent profile analysis revealed 3 mindfulness profiles “high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness/ judgmentally observing” group (i.e., relatively low-to-average on describing, and non-reacting facets of mindfulness and  high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).

 

For both the military personnel and the students, the participants with the “high mindfulness” profile had significantly better mental health than those with the other profiles including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. It is important to note that the results were similar in very different participant populations, suggesting that the results are generalizable.

 

The results further suggest that with mindfulness there are very different types of people, expressing mindfulness in different ways and this makes a difference in the relationship of mindfulness to mental health. The results suggest that overall being mindful is associated with good mental health. They further suggest that being generally high on all facets of mindfulness is an even better predictor of good mental health. It may make sense in future research to pay more attention to these different mindfulness profile groups in investigating mindfulness relationships with mental and physical well-being.

 

It is clear that mindfulness is associated with better mental health.

 

“We’ve seen this in the clinical domain for many years. People, in concert with their physicians… actually going off their medications for pain, for anxiety, for depression, as they begin to learn the self-regulatory elements of mindfulness. They discover that the things that used to be symptomatically problematic for them are no longer arising at the same level.” – Jon Kabat-Zinn

 

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

 

Bravo, A. J., Pearson, M. R., & Kelley, M. L. (2017). Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students. Mindfulness, 9(1), 258-270.

 

Abstract

Previous research on trait mindfulness facets using person-centered analyses (e.g., latent profile analysis [LPA]) has identified four distinct mindfulness profiles among college students: a high mindfulness group (high on all facets of the Five-Factor Mindfulness Questionnaire [FFMQ]), a judgmentally observing group (highest on observing, but low on non-judging of inner experience and acting with awareness), a non-judgmentally aware group (high on non-judging of inner experience and acting with awareness, but very low on observing), and a low mindfulness group (low on all facets of the FFMQ). In the present study, we used LPA to identify distinct mindfulness profiles in a community based sample of U.S. military personnel (majority veterans; n = 407) and non-military college students (n = 310) and compare these profiles on symptoms of psychological health outcomes (e.g., suicidality, PTSD, anxiety, rumination) and percentage of participants exceeding clinically significant cut-offs for depressive symptoms, substance use, and alcohol use. In the subsample of college students, we replicated previous research and found four distinct mindfulness profiles; however, in the military subsample we found three distinct mindfulness profiles (a combined low mindfulness/judgmentally observing class). In both subsamples, we found that the most adaptive profile was the “high mindfulness” profile (i.e., demonstrated the lowest scores on all psychological symptoms and the lowest probability of exceeding clinical cut-offs). Based on these findings, we purport that the comprehensive examination of an individual’s mindfulness profile could help clinicians tailor interventions/treatments that capitalize on individual’s specific strengths and work to address their specific deficits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/

 

Mindfulness is Associated with Fewer Worries about Cessation of the Use of Sleeping Pills for Insomnia

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Mindfulness is Associated with Fewer Worries about Cessation of the Use of Sleeping Pills for Insomnia

 

By John M. de Castro, Ph.D.

 

“If insomnia is at the root of your sleepless nights, it may be worth trying meditation. The deep relaxation technique has been shown to increase sleep time, improve sleep quality, and make it easier to fall (and stay) asleep.” – National Sleep Foundation

 

It is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. Yet over 70 million Americans suffer from disorders of sleep and about half of these have a chronic disorder. It has been estimated that about 4% of Americans revert to sleeping pills. But, these do not always produce high quality sleep and can have problematic side effects. In addition, these medications can become addictive such that the individual cannot sleep without them. So, there is a need to find better methods to improve sleep.

 

Mindfulness-based practices have been reported to improve sleep amount and quality and to help treat addictions. Indeed, Mindfulness-based Relapse Prevention (MBRP) was developed to specifically assist in relapse prevention and has been shown to be effective. In today’s Research News article “Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856331/ ), Barros and colleagues examined the relationship between mindfulness and addiction to sleeping pills in women.

 

They recruited adult women who used sleeping pills on a daily basis and had them complete paper and pencil measures of mindfulness, insomnia severity, anxiety, and dependence on sleeping pills, including problematic use, preoccupation with availability, lack of compliance with prescription, and withdrawal symptoms. They performed a regression analysis to examine the relationships between these variables.

 

They found that the higher the levels of mindfulness and particularly the observing facet of mindfulness, the lower the preoccupation with the availability of sleeping pills. This preoccupation frequently involves anxiety about not having the medication available for use. In addition, the higher the levels of mindfulness and particularly the non-reacting facet of mindfulness, the lower the lack of compliance with prescription. The women with high mindfulness were less likely to use the sleeping pills more often or in different circumstances than prescribed by their physician. Finally, the higher the levels of the mindfulness facets of observing and non-reacting, the lower the belief that withdrawal would produce severe uncomfortable experiences.

 

This study was correlative and as such conclusions regarding causation cannot be reached, Nevertheless, the results suggest that the levels of mindfulness prior to treatment for sleeping pill addiction are associated with the characteristics of the addiction and the patients’ anxieties regarding the availability of the pills and the consequences of withdrawal. This suggests that more mindful women would find it easier to withdraw from their use and treatment for the addiction would be more likely to be effective. It remains for future research to examine whether high levels of mindfulness prior to treatment is predictive of greater success in treatment.

 

“Imagine a country where we no longer have to depend on medication to help manage depression, chronic pain, or insomnia. . . mindfulness is just as effective as side-effect loaded medications. “ – Ruth Buczynski

 

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

 

Barros, V. V., Opaleye, E. S., Demarzo, M., Bowen, S., Curado, D. F., Hachul, H., & Noto, A. R. (2018). Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study. PLoS ONE, 13(3), e0194035. http://doi.org/10.1371/journal.pone.0194035

 

Abstract

Introduction

Dispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder.

Objective

To evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users.

Design and method

Seventy-six women, chronic users of hypnotics, who resorted to Mindfulness-Based Relapse Prevention for the cessation of hypnotic use were included in the study. The Five Facet Mindfulness Questionnaire (FFMQ) evaluated the levels and facets of mindfulness, and the subscales of the Benzodiazepine Dependence Questionnaire (BENDEP) assessed dependence on hypnotics. We also evaluated sociodemographic variables and symptoms of insomnia and anxiety. The associations between the FFMQ facets and the BENDEP subscales were evaluated with binomial logistic regression, adjusted for income, schooling, anxiety, and insomnia.

Results

We observed associations between facets of the FFMQ and specific aspects of hypnotic dependence. The facet “observing” was inversely associated with the “concern about lack of availability of the hypnotic” [aOR = 0.87 95% CI (0.79–0.97)], and the facet “non-reacting to inner experience” with “noncompliance with the prescription recommendations” [aOR = 0.86 95% CI (0.75–0.99)]. The total score of the FFMQ was inversely associated to those two dependence subscales [aOR = 0.94 95% CI (0.89–0.99)]. “Observing” and “non-reactivity to inner experience” were also inversely associated with the “impairments related to the withdrawal symptoms” [aOR = 0.84 95% CI (0.73–0.97)] and [aOR = 0.78 95% CI (0.63–0.96)], respectively. The FFMQ was not associated with “awareness of problematic hypnotic use”.

Conclusion

Dispositional mindfulness, specifically the facets “observing” and “non-reactivity to inner experience, were inversely associated with the components of hypnotic dependence related to the anticipation of having the substance, its expected effect, and the impairments caused by the abstinence. We discuss the implications of those results for the clinical practice and future investigations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856331/

Reduce Use and Improve the Mental Health of Adults with Stimulant Addiction with Mindfulness

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Reduce Use and Improve the Mental Health of Adults with Stimulant Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When stimulant users attempt to quit, some of the most frequent complaints have to do with intolerable feelings of depression, sadness, and anxiety, conditions that often lead people to drop out of treatment early. Mindfulness practice not only helps them to manage cravings and urges, but also enables them to better cope with the psychological discomfort that can precipitate a relapse.” – Suzette Glasner

 

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

 

In today’s Research News article “Mindfulness Based Relapse Prevention for Stimulant Dependent Adults: A Pilot Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300086/ ), Glasner-Edwards and colleagues recruited stimulant (cocaine or amphetamine) dependent adults. All participants participated in a contingency management program which involved receiving rewards for drug clean urine samples. Participants were randomly assigned to receive an 8-week program of Mindfulness-based Relapse Prevention (MBRP) or health education. They were measured before and after treatment and 1 month later for stimulant use (urine test), stimulant dependence, anxiety disorders, depression, emotion regulation, thought suppression, and mindfulness.

 

They found that the (MBRP) program resulted in significantly lower levels of severity of psychiatric disorders, depression and anxiety at follow-up than those in the health education condition. In addition, for two psychiatric subgroups, participants with major depressive disorder or anxiety disorder, participation in the (MBRP) program resulted in significantly lower use of stimulants than those in the health education condition.

 

These are exciting results that suggest that participation in a Mindfulness-based Relapse Prevention (MBRP) can significantly improve psychiatric symptoms and mood in stimulant dependent individuals and reduce stimulant use participants who suffered from major depression or anxiety disorder. Drug abuse is difficult to treat and even when successful relapse is likely. So, programs like (MBRP) that can be of assistance in reducing the abuse and the mental health of the abusers may be very valuable. This program was far from a cure and much more research and development is needed.

 

So, reduce use and improve the mental health of adults with stimulant addiction with mindfulness.

 

“Incorporating mindfulness into cognitive-behavioral therapy may prove to be helpful for people looking to manage their drug addictions more successfully. . . it could be especially helpful for reducing stimulant relapse rates in people with anxiety and depression.” – Two Dreams

 

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

 

Glasner-Edwards, S., Mooney, L. J., Ang, A., Garneau, H. C., Hartwell, E., Brecht, M.-L., & Rawson, R. A. (2017). Mindfulness Based Relapse Prevention for Stimulant Dependent Adults: A Pilot Randomized Clinical Trial. Mindfulness, 8(1), 126–135. http://doi.org/10.1007/s12671-016-0586-9

 

Abstract

In light of the known associations between stress, negative affect, and relapse, mindfulness strategies hold promise as a means of reducing relapse susceptibility. In a pilot randomized clinical trial, we evaluated the effects of Mindfulness Based Relapse Prevention (MBRP), relative to a health education control condition (HE) among stimulant dependent adults receiving contingency management. All participants received a 12-week contingency management (CM) intervention. Following a 4-week CM-only lead in phase, participants were randomly assigned to concurrently receive MBRP (n=31) or HE (n=32). Stimulant dependent adults age 18 and over. A university based clinical research center. The primary outcomes were stimulant use, measured by urine drug screens weekly during the intervention and at 1-month post-treatment, negative affect, measured by the Beck Depression Inventory and Beck Anxiety Inventory, and psychiatric severity, measured by the Addiction Severity Index. Medium effect sizes favoring MBRP were observed for negative affect and overall psychiatric severity outcomes. Depression severity changed differentially over time as a function of group, with MBRP participants reporting greater reductions through follow-up (p=0.03; Effect Size=0.58). Likewise, the MBRP group evidenced greater declines in psychiatric severity, (p=0.01; Effect Size=0.61 at follow-up). Among those with depressive and anxiety disorders, MBRP was associated with lower odds of stimulant use relative to the control condition (Odds Ratio= 0.78, p=0.03 and OR=0.68, p=0.04). MBRP effectively reduces negative affect and psychiatric impairment, and is particularly effective in reducing stimulant use among stimulant dependent adults with mood and anxiety disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300086/

 

Mindfulness is Associated with Reduced Pain by Improving the Capacity for Pleasure

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Mindfulness is Associated with Reduced Pain by Improving the Capacity for Pleasure

 

By John M. de Castro, Ph.D.

 

“It felt good to realize [through mindfulness] that I can co-exist with my pain. Being mindful helped me realize that in my angry reaction to my back pain, I was neglecting my whole body. I saw my body only through my pain, which caused me to hate my body over time. I can now see myself outside of my body, and am working day by day with my meditation to become a happier person living with chronic pain.” – Natalia Morone

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults. But there is very little systematic study of how these practices effect chronic pain.

 

In today’s Research News article “Mindfulness Is Associated with Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5235319/ ), Thomas and Garland recruited chronic pain patients who were being treated with opioids. They were measured for mindfulness, hedonic (pleasure) capacity, pain severity, pain interference, and depression. The relationships among these variables was explored with regression analysis.

 

They found that for the higher the levels of mindfulness for these chronic pain patients the higher their ability to experience pleasure (hedonic capacity) and the less that pain interfered with their daily lives (pain interference). This was also true for the mindfulness facets of observing inner experience, non-judgment, and acting with awareness. A mediation analysis demonstrated that the association of mindfulness with less pain interference in daily living resulted from mindfulness’ association with higher levels of hedonic capacity that in turn was associated with lower pain interference. So, the higher levels of ability to experience pleasure associated with mindfulness was the mediator of mindfulness’ association with lower ability of pain to interfere with living.

 

It needs to be kept in mind that this study was correlational and causation cannot be determined. But, the results suggest that being mindful predicts a greater ability to experience pleasure and, in turn, less interference in daily life produced by pain. This makes sense as pleasure occurs in the present moment and the ability of mindfulness to focus attention on the present moment would heighten the appreciation of this pleasure. In turn, it makes sense that being able to experience the good things in life would interfere with the ability of pain to interfere with living. So, being mindful may heighten the appreciation of pleasure and lower the difficulties in daily living produced by chronic pain.

 

“The current state of chronic pain and opioid use in the United States may indeed be daunting and require a multifaceted approach; yet, there is promise for our Veterans and the more than 100 million Americans1 who suffer from chronic pain in the age-old and now richly evidence-based practice of mindfulness meditation.” – Dawn Bazarko

 

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

 

Thomas, E. A., & Garland, E. L. (2017). Mindfulness Is Associated with Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy. The Clinical Journal of Pain, 33(2), 166–173. http://doi.org/10.1097/AJP.0000000000000379

 

Abstract

Objectives

Chronic pain and long-term opioid use may lead to a persistent deficit in hedonic capacity, characterized by increased sensitivity to aversive states and insensitivity to natural rewards. Dispositional mindfulness has been linked with improved emotion regulation and pain coping. The aim of the current study was to examine associations between dispositional mindfulness, hedonic capacity, and pain-related interference in an opioid-using chronic pain sample.

Methods

Data were obtained from a sample of 115 chronic pain patients on long-term opioid therapy (68% females, M age=48.3, SD=13.6) who completed the Five Facet Mindfulness Questionnaire (FFMQ), the Snaith Hamilton Anhedonia and Pleasure Scale (SHAPS), the Brief Pain Inventory (BPI), and a psychiatric assessment of major depression. Bivariate correlations, hierarchical multiple regression, and path analysis were used to determine if dispositional mindfulness scores (FFMQ) predicted variance in hedonic capacity (SHAPS), and if hedonic capacity mediated the association between mindfulness and pain interference.

Results

We observed a significant positive correlation between dispositional mindfulness and hedonic capacity scores, r=.33, p<.001. Hierarchical regression indicated that after controlling for pain interference and major depressive disorder diagnosis, dispositional mindfulness explained a significant portion of variance in hedonic capacity (Beta = .30, p< .01). The association between dispositional mindfulness and pain interference was mediated by hedonic capacity (b = −.011, SE=.005, 95% C.I. = −.004 to −.024, full model R2=.39).

Discussion

Findings indicate that dispositional mindfulness was associated with hedonic capacity among this chronic pain sample. In light of this association, it is plausible that interventions that increase mindfulness may reduce pain-related impairment among opioid-using patients by enhancing hedonic capacity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5235319/

 

Reduce Substance Abuse with Yoga

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Reduce Substance Abuse with Yoga

By John M. de Castro, Ph.D.

 

“When people take substances, they’re seeking a certain experience, whether it’s escapist or transcendental or just wanting a different psychological state, to get away from whatever is making them unhappy. Yoga is an alternative, a positive way to generate a change in consciousness that, instead of providing an escape, empowers people with the ability to access a peaceful, restorative inner state that integrates mind, body, and spirit.” – Sat Bir Khalsa

 

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. “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).

 

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 both treat substance abuse disorders and to prevent relapses. Mindfulness practices have been shown to improve recovery from various addictions. Yoga is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. There has been a paucity of studies, however, on the use of yoga practice to treat substance abuse.

 

In today’s Research News article “Role of Yoga in Management of Substance-use Disorders: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/ ), Kuppili and colleagues review and summarize the published research literature on the application of yoga practice for the treatment of substance abuse. They found 16 studies, 12 of which were randomized controlled trials.

 

There were 9 studies of yoga practice as a treatment for nicotine (smoking) addiction. These studies reported that yoga practice increased the desire to quit smoking, reduced cravings for cigarettes, and assisted in quitting. There were, however, mixed findings on the duration of these effects. There were 3 studies of yoga practice as a treatment for alcohol use disorders. These studies reported that yoga practice was helpful in reducing alcohol intake and depression. There were 3 studies of yoga practice as a treatment for opioid use disorders. These studies reported that yoga practice for patients undergoing treatment improved mood states and quality of life. There was only 1 study of yoga practice as a treatment for cocaine use disorder and reported improvements in perceived stress and quality of life.

 

The studies reviewed suggest that yoga practice may be of use in the treatment of substance use disorders particularly in improving the psychological state of patients under treatment and perhaps reducing cravings. There is obviously, though, a need for more studies with larger samples and with long-term follow-up. Yoga practice does not appear to a magical cure for substance abuse but may be helpful to the patient in kicking the habit. Clearly yoga practice has substantial psychological and physical benefits for practitioners and these in combination with its helpfulness for the treatment of substance abuse make it a reasonable choice for improving he well-being of patients with these disorders.

 

“Yoga is a complementary, or adjunct, health practice that is often considered a natural form of medicine. Adjunct means “in addition to,” and not “in place of.” Yoga is often beneficial when used in tandem with other traditional substance abuse treatment methods.” – American Addiction Centers

 

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

 

Pooja Patnaik Kuppili, Arpit Parmar, Ankit Gupta, Yatan Pal Singh Balhara. Role of Yoga in Management of Substance-use Disorders: A Narrative Review. J Neurosci Rural Pract. 2018 Jan-Mar; 9(1): 117–122. doi: 10.4103/jnrp.jnrp_243_17

 

Abstract

Substance use disorders are comparable to chronic medical illnesses and have a chronic relapsing course. Despite being significant contributors to morbidity and mortality, limited treatment options exist. The current narrative review was aimed at providing an overview of yoga therapy in substance-use disorders and discuss the relevant methodological issues. Articles published in English language till May 2017 indexed with PubMed, PubMed central, and Google Scholar were searched using search terms “Yoga,” “Substance use,” “Drug dependence,” “Nicotine,” “Tobacco,” “Alcohol,” “Opioids,” “Cannabis,” “Cocaine,” “Stimulants,” “Sedative hypnotics,” “Inhalants,” and “Hallucinogens” for inclusion in the review. A total of 314 studies were found fulfilling the stated criteria. Out of which, 16 studies were found to fulfill the inclusion and exclusion criteria and 12 were randomized control trials. The majority of studies were available on the role of yoga in management of nicotine dependence. Sample size of these studies ranged from 18 to 624. The majority of studies suggested the role of yoga in reducing substance use as well as substance-related craving (especially in nicotine-use disorders) in short term. However, more studies are required for demonstrating the long-term effects of yoga therapy in substance-use disorder.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/

 

Slightly Improve Substance Use Disorder with Mindfulness

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Slightly Improve Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses.

 

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

 

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

 

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

 

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

 

So, slightly improve substance use disorder with mindfulness.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Objectives:

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

Methods:

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

Results:

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

Conclusions:

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

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

Reduce Drug Addiction and Prison Recidivism with Mindfulness

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Reduce Drug Addiction and Prison Recidivism with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

So, reduce drug addiction and prison recidivism with mindfulness.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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