Reduce Opioid-Treated Pain and Opioid Dosage with Mindfulness

Reduce Opioid-Treated Pain and Opioid Dosage with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mind-body therapies — including meditation, cognitive behavioral therapy and hypnosis — were associated with improvements in pain and reduced opioid doses.” – Erin Michael

 

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.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. What is not known is the most effective mind-body treatments for chronic pain. There are a large variety of mind-body therapies including meditation, hypnosis, relaxation, guided imagery, therapeutic suggestion, and Cognitive Behavioral Therapy (CBT). It is not known which are the most effective for reducing pain and opioid use in patients with chronic pain who are being treated with opioids.

 

In today’s Research News article “Mind-Body Therapies for Opioid-Treated Pain: 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/PMC6830441/ ) Garland and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body techniques for opioid-treated pain. They identified 60 published trials.

 

They report that the published research found that the studies that used Mind-Body Therapies produced significant reductions in pain outcomes and opioid use. This was true for studies that employed meditation, hypnosis, or Cognitive Behavioral Therapy (CBT), with the largest effect sizes found for meditation. Suggestion, imagery, and relaxation were all found to be less effective.

 

Hence, the published randomized controlled trials support the use of Mind-Body Therapies for the treatment of patients with chronic pain who are being treated with opioids. Meditation, hypnosis, or Cognitive Behavioral Therapy (CBT) are particularly effective in both treating pain and reducing opioid use. This is compatible with other results that mindfulness meditation has been repeatedly shown to reduce pain and improve recovery from opioid addiction.

 

Meditation, hypnosis, or Cognitive Behavioral Therapy (CBT) have a common property of changing the patient’s thought patterns associated with their pain and thereby alter their relationship with the pain. These thought patterns such as worry, rumination, and catastrophizing tend to amplify the physical pain. Reducing these tendencies can eliminate the amplification and thereby reduce the experienced pain. With less pain, less opioids are needed to control it.

 

So, reduce opioid-treated pain and opioid dosage with mindfulness.

 

Using mindfulness, meditation, hypnosis, therapeutic suggestion, and cognitive behavior therapy, in addition to opioid treatment of acute or chronic pain, provides an additional benefit to patients by reducing pain scores. Some of these interventions will decrease the duration or amount of opioid needed.” – Sumi Sexton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Garland, E. L., Brintz, C. E., Hanley, A. W., Roseen, E. J., Atchley, R. M., Gaylord, S. A., Faurot, K. R., Yaffe, J., Fiander, M., & Keefe, F. J. (2019). Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis. JAMA internal medicine, 180(1), 91–105. Advance online publication. https://doi.org/10.1001/jamainternmed.2019.4917

 

Key Points

Question

Are mind-body therapies (ie, meditation, hypnosis, relaxation, guided imagery, therapeutic suggestion, and cognitive behavioral therapy) associated with pain reduction and opioid-related outcome improvement among adults using opioids for pain?

Findings

In this systematic review and meta-analysis of 60 randomized clinical trials with 6404 participants, mind-body therapies were associated with improved pain (Cohen d = −0.51; 95% CI, −0.76 to −0.27) and reduced opioid dose (Cohen d = −0.26; 95% CI, −0.44 to −0.08).

Meaning

Practitioners should be aware that mind-body therapies may be associated with moderate improvements in pain and small reductions in opioid dose.

Abstract

Importance

Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.

Objective

To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.

Data Sources

For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.

Study Selection

Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain.

Data Extraction and Synthesis

Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs.

Main Outcomes and Measures

The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function.

Results

Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = −0.51; 95% CI, −0.76 to −0.26) and reduced opioid dose (Cohen d = −0.26; 95% CI, −0.44 to −0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = −0.70), hypnosis (Cohen d = −0.54), suggestion (Cohen d = −0.68), and cognitive behavioral therapy (Cohen d = −0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias.

Conclusions and Relevance

The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830441/Importance

Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.

Reduce the Impact of Problematic Social Media Use on Depression During the Covid-19 Pandemic with Mindfulness

Reduce the Impact of Problematic Social Media Use on Depression During the Covid-19 Pandemic with Mindfulness

 

By John M. de Castro, Ph.D.

 

Social media addiction is becoming an increasing problem. . . Mindfulness is a training that helps us become more present, self aware and better able to respond rather than react on autopilot in our everyday lives. It’s been shown to help with impulse control . . .and is a powerful tool for kicking addictions ranging from drugs, to social media.” – Elise Bialylew

 

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

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravingsimpulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. It also has been found to be helpful in overcoming internet and smartphone addictions.

 

Problematic use of the internet and social media has been amplified by the Covid-19 pandemic. It has produced social isolation and interacting over the internet is one of the few means available to communicate. It is not known the extent to which mindfulness may help to prevent social media use from becoming problematic promoting fear and depression.

 

In today’s Research News article “Relationship Between Problematic Social Media Usage and Employee Depression: A Moderated Mediation Model of Mindfulness and Fear of COVID-19.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.557987/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1514613_69_Psycho_20201224_arts_A ) Majeed and colleagues recruited adult Pakistanis who were employed during the Covid-19 lockdown. The participants completed online questionnaires measuring problematic social media usage, fear of Covid-19, depression, and mindfulness.

 

They found that the greater the problematic social media usage, the greater the fear of Covid-19, and depression and the lower the level of mindfulness. In addition, the greater the fear of Covid-19, the greater the level of depression and the lower the level of mindfulness. Finally, the greater the level of mindfulness the lower the level of depression. They performed a mediation analysis and found that the fear of Covid-19 mediated the positive relationship of problematic social media usage with depression such that problematic social media usage was associated with greater fear of Covid-19, which was, in turn, associated with greater depression. They further found that this mediation was moderated by mindfulness such that the higher the levels of mindfulness the weaker the mediation of fear of Covid-19.

 

These are correlative findings and as such must be interpreted with caution. But they show that higher problematic social media usage is associated with depression via fear of Covid-19 and this mediation is dampened by mindfulness. “Problematic social media usage is defined as; an excessive use of social media regularly, to the extent that it seems difficult to stay away from it.” It can be speculated that overuse of social media during the pandemic reinforces the fear of the disease and this fear in a lockdown context promotes depression.

 

Mindfulness appears to be somewhat of an antidote reducing the impact of the social media use on fear and depression. To some extent this is not surprising as mindfulness has been repeatedly shown to decrease depression and fear. Mindfulness also has been found to be helpful in overcoming internet and smartphone addictions. What is new here is the effect of mindfulness on the lowering the impact of social media use on fear and depression during a pandemic.

 

So, reduce the impact of problematic social media use on depression during the Covid-19 pandemic with mindfulness.

 

compulsive mobile SNS use induces stress and that mindfulness has also lowering effects on stress derived from such compulsive behavior,” – Vanessa Apaolaza

 

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

 

Majeed M, Irshad M, Fatima T, Khan J and Hassan MM (2020) Relationship Between Problematic Social Media Usage and Employee Depression: A Moderated Mediation Model of Mindfulness and Fear of COVID-19. Front. Psychol. 11:557987. doi: 10.3389/fpsyg.2020.557987

 

Social media plays a significant role in modern life, but excessive use of it during the COVID-19 pandemic has become a source of concern. Supported by the conservation of resources theory, the current study extends the literature on problematic social media usage during COVID-19 by investigating its association with emotional and mental health outcomes. In a moderated mediation model, this study proposes that problematic social media use by workers during COVID-19 is linked to fear of COVID-19, which is further associated with depression. The current study tested trait mindfulness as an important personal resource that may be associated with reduced fear of COVID-19 despite problematic social media use. The study collected temporally separate data to avoid common method bias. Pakistani employees (N = 267) working in different organizations completed a series of survey questionnaires. The results supported the moderated mediation model, showing that problematic social media use during the current pandemic is linked to fear of COVID-19 and depression among employees. Furthermore, trait mindfulness was found to be an important buffer, reducing the negative indirect association between problematic social media use and depression through fear of COVID-19. These results offer implications for practitioners. The limitations of this study and future research directions are also discussed.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.557987/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1514613_69_Psycho_20201224_arts_A

 

Change Behavior for the Better with Mindfulness

Change Behavior for the Better with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness practice supports and facilitates behavior change through training attention, emotion, and self-awareness.” – Yi-Yuan Tang

 

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.

 

Problems can also be produced by lack of appropriate behavior such as sedentary lifestyle, not eating a healthy diet, not getting sufficient sleep or rest, or failing to take medications according to the physician’s orders. Additionally, behavioral issues can be subtle contributors to disease such as denying a problem and failing to see a physician timely or not washing hands. In fact, many modern health issues, costing the individual or society billions of dollars each year, and reducing longevity, are largely preventable.

 

Hence, promoting healthy behaviors and eliminating unhealthy ones has the potential to markedly improve health. Mindfulness training has been shown to promote health and improve illness. It is well established that mindfulness can improve healthy behaviors. The research has been accumulating. So, it is reasonable to stop and summarize what has been learned. In today’s Research News article “Mindfulness and Behavior Change.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647439/ )  Schuman-Olivier and colleagues review and summarize the published research on the ability of mindfulness training to promote healthy behaviors.

 

They report that the published studies found that mindfulness training reduces cravings and produces improvements in alcohol and substance abuse disorders, binge eating disorder, obesity, improves smoking cessation, reduces emotional eating and eating when not hungry and produces weight reduction. Mindfulness training has been shown to improve self-management of chronic diseases, including hypertension, COPD, and diabetes and results in improvements in quality of life and reductions in anxiety and depression. Mindfulness training also reduces impulsive behavior, risky sexual behavior, aggression, and violent behaviors. It also reduces self-injury, suicidal thinking, and suicidal behavior.

 

The authors go on to produce and discuss a model of how mindfulness training may be improving troubling behaviors. They speculate that mindfulness training produces a general improvement in self-regulation which results in improved control of behavior. This self-regulation is produced by improvements in attention and cognitive control, emotion regulation, and self-related processes, as well as motivation and learning ability. Regardless, it is clear that mindfulness training improves behaviors that can lead to or exacerbate illness. It’s actually amazing that such simple practices can have such profound and widespread effects in promoting health and well-being and treating diseases.

 

So, change behavior for the better with mindfulness.

 

On your path to create change invite compassion and embrace and accept where you are. Only from a place of compassion will your efforts move into fruition. What is the next compassionate step you can make towards this change today?” – Carley Hauck

 

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

 

Schuman-Olivier, Z., Trombka, M., Lovas, D. A., Brewer, J. A., Vago, D. R., Gawande, R., Dunne, J. P., Lazar, S. W., Loucks, E. B., & Fulwiler, C. (2020). Mindfulness and Behavior Change. Harvard review of psychiatry, 28(6), 371–394. https://doi.org/10.1097/HRP.0000000000000277

 

Abstract

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

CONCLUSION

A growing evidence base supports the benefits of mindfulness for behavior change. A mindful self-regulation model based on an integration of neuroscientific findings describes the complex and synergistic effects of attention/cognitive control, emotion regulation, and self-related processes, as well as motivation and learning mechanisms that may provide a unique pathway toward sustainable behavior change. While evidence supports the impact of mindfulness on behavior change for key health behaviors related to psychiatric practice, more high-quality research is needed, especially with objective measures, larger samples, replication studies, active controls, and formal monitoring of adverse events.474 The field will also benefit from additional research on the impact of integrating compassion practices and from a focus on trauma-sensitive adaptations for diverse populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647439/

 

Acceptance and Commitment Therapy is Effective in Treating Substance Use Disorders

Acceptance and Commitment Therapy is Effective in Treating Substance Use Disorders

 

By John M. de Castro, Ph.D.

 

“Mindfulness reminds us that in stillness we find the wisdom to become a human being instead of a human doing. . .  Recovery is a journey, not a destination. Stillness opens our hearts and minds to the vast potential within us as we move through treatment.” – Beverly Conyers

 

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

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictionsAcceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

The evidence has been accumulating on the effectiveness of Acceptance and Commitment Therapy (ACT) for the treatment of substance use disorders. So, it makes sense to step back and summarize what has been learned in the most recent studies. In today’s Research News article “The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524566/ ) Osaji and colleagues review and summarize the published research on the effectiveness of ACT in treating patients with substance use disorders.

 

They identified 22 published research studies and report that the published research found that  Acceptance and Commitment Therapy (ACT) was effective for the treatment of substance use disorders. They report that the research demonstrates that ACT is effective when used alone or in combination with other therapies. ACT successfully reduced substance use or produced discontinuation. It has been shown that various forms of mindfulness training are effective in treating addictions. The present findings simply extends this to ACT.

 

So, Acceptance and Commitment Therapy is effective in treating substance use disorders.

 

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

 

“mindfulness can play a very important role in substance abuse recovery: patients learn how to rethink the nature of stressful situations and stimuli that may otherwise trigger a harmful train of thought that leads to drinking or using. Prior to a mindfulness intervention, patients may have been oblivious to the various factors that start the chain reaction of negative thought and unhealthy behavior. Mindfulness treatment gives them the chance to examine those factors on a level playing field, in a calm, supportive and safe environment. In time, the triggers become less daunting and more manageable.” – Foundations Recovery Network

 

Study Summary

 

Osaji, J., Ojimba, C., & Ahmed, S. (2020). The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. Journal of Clinical Medicine Research, 12(10), 629–633. https://doi.org/10.14740/jocmr4311

 

Abstract

Background

Acceptance and commitment therapy (ACT) is a form of behavioral therapy that teaches people to learn to accept rather than avoid challenging situations in their lives. ACT has shown to be an intervention with great success in the reduction of various mental disorders and substance use disorders (SUDs). The core of ACT when used in SUD treatment is guiding people to accept the urges and symptoms associated with substance misuse (acceptance) and use psychological flexibility and value-based interventions to reduce those urges and the symptoms (commitment). The purpose of this study is to review the existing literature to examine the evidence on the use of ACT in the management of SUD.

Methods

A thorough search of four databases (CINAHL, PubMed.gov, PsycINFO and PsycNET) from 2011 to 2020 was conducted using search terms like ACT, ACT and SUD, ACT, and substance misuse. The articles retrieved were critically appraised using the Critically Appraised Topic (CAT) Checklist.

Results

Most of the studies showed that ACT was effective in the management of SUD showing significant evidence of a reduction in substance use or total discontinuation with subsequent abstinence.

Conclusions

The literature review concluded that success has been achieved using ACT either as monotherapy or in combination with other therapy in the treatment of individuals with SUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524566/

 

Reduce Opioid Use after Surgery for Orthopedic Trauma with Mindfulness

Reduce Opioid Use after Surgery for Orthopedic Trauma with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids. An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates.

 

An encouraging alternative is mindfulness training. It has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings for opioids. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet has been developed. This has the tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. Hence it would make sense to study ACT delivered over the internet to reduce opioid use with pain patients.

 

In today’s Research News article “Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458063/ ) Anthony and colleagues recruited hospital patients who had a bone fracture requiring surgery and randomly assigned them to a treatment as usual control condition or to receive automated text based messages communicating a Acceptance and Commitment Therapy (ACT) message twice a day for the two weeks following surgery.

A day 1 example message was:

Maintaining focus on what you value most in life is sometimes difficult after surgery. Do not let the momentary discomforts due to surgery take away from what you want most in life. Pick 3 things that matter most to you in life. Remind yourself of these 3 things you value most during your recovery process.”

They were measured before and after the 2-week messaging period for opioid use, pain intensity, pain interference, and anxiety.

 

They found that although both groups were prescribed the same amount of opioids after surgery, the Acceptance and Commitment Therapy (ACT) message group consumed significantly fewer, 37% less, opioid pills during the 2 weeks following surgery than the control group. In addition, the ACT group reported significantly lower pain intensity and pain interference than the control group two weeks after surgery.

 

The ability of Acceptance and Commitment Therapy (ACT) to reduce perceived pain and to reduce opioid use have been previously documented. The important contribution of the present study is that it demonstrated that these benefits can be attained with ACT taught through automated text messages. This suggests that the benefits of the therapy can be provided routinely, inexpensively and conveniently to large numbers of patients. Although there was no long term follow up, it would be hoped that this treatment would result in lower likelihood of opioid addiction resulting from post-surgical use in these patients.

 

So, reduce opioid use after surgery for orthopedic trauma with mindfulness.

 

People suffering from opioid addiction and chronic pain may have fewer cravings and less pain if they use both mindfulness techniques and medication for opioid dependence.” – Science Daily

 

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

 

Anthony, C. A., Rojas, E. O., Keffala, V., Glass, N. A., Shah, A. S., Miller, B. J., Hogue, M., Willey, M. C., Karam, M., & Marsh, J. L. (2020). Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial. Journal of medical Internet research, 22(7), e17750. https://doi.org/10.2196/17750

 

Abstract

Background

Acceptance and commitment therapy (ACT) is a pragmatic approach to help individuals decrease avoidable pain.

Objective

This study aims to evaluate the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid use and patient-reported outcomes (PROs) in patients with orthopedic trauma who underwent operative intervention for their injuries.

Methods

Adult patients presenting to a level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture and who used mobile phone text messaging were eligible for the study. Patients were randomized in a 1:1 ratio to either the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first 2 weeks after surgery, or the control group, who received no messages. Baseline PROs were completed. Two weeks after the operative intervention, follow-up was performed in the form of an opioid medication pill count and postoperative administration of PROs. The mean number of opioid tablets used by patients was calculated and compared between groups. The mean PRO scores were also compared between the groups.

Results

A total of 82 subjects were enrolled in the study. Of the 82 participants, 76 (38 ACT and 38 controls) completed the study. No differences between groups in demographic factors were identified. The intervention group used an average of 26.1 (SD 21.4) opioid tablets, whereas the control group used 41.1 (SD 22.0) tablets, resulting in 36.5% ([41.1-26.1]/41.1) less tablets used by subjects receiving the mobile phone–based ACT intervention (P=.004). The intervention group subjects reported a lower postoperative Patient-Reported Outcome Measure Information System Pain Intensity score (mean 45.9, SD 7.2) than control group subjects (mean 49.7, SD 8.8; P=.04).

Conclusions

In this study, the delivery of an ACT-based intervention via an automated mobile messaging robot in the acute postoperative period decreased opioid use in selected patients with orthopedic trauma. Participants receiving the ACT-based intervention also reported lower pain intensity after 2 weeks, although this may not represent a clinically important difference.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458063/

 

Improve Substance Abuse Disorders with Mindfulness-Based Treatments

Improve Substance Abuse Disorders with Mindfulness-Based Treatments

 

By John M. de Castro, Ph.D.

 

“incorporating mindfulness exercises into treatment is especially helpful for those of us who have struggled with addiction to alcohol, drugs, porn, unhealthy relationships, or other destructive behaviors.” – Beverly Conyers

 

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

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. The evidence has been accumulating so it makes sense to step back and summarize what has been learned in the most recent studies.

 

In today’s Research News article “Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392831/) Korecki and colleagues review and summarize the recently (2016-2020) published randomized controlled trials on the effectiveness of manualized mindfulness programs in treating substance abuse and preventing relapse. They identified 30 published randomized controlled trials employing mindfulness-based treatments that used structured protocols; were manualized.

 

They report that the published studies utilized a wide variety of mindfulness-based treatment protocols including Mindfulness-Based Relapse Prevention (MBRP), Mindfulness Oriented Recovery Enhancement (MORE), Mindfulness Training for Smokers (MTS), Moment-by-Moment in Women’s Recovery (MMWR), Mindfulness-Based Addiction Treatment (MBAT), and Mindful Awareness in Body-Oriented Therapy (MABT). These protocols have varied targeted components to address different addictions or different populations of addicts. But they have the common property of training in present moment awareness (mindfulness).

 

They report that the studies demonstrated that these Mindfulness-Based treatments were as effective and sometimes more effective than other existing evidenced-based treatments in treating substance use disorders. They report that these treatments significantly reduced the frequency of drug or alcohol use, the amounts of drugs or alcohol used, problems related to substance abuse, and cravings for the drugs or alcohol. In addition, they increased the rate of abstinence in the substance abuse patients.

 

This review of the most recent studies suggests that the use of mindfulness-based treatments for the treatment of substance abuse disorder are safe and effective on a level with or superior to other existing treatments. Future research should investigate the cost-effectiveness of the various treatments and which protocols work best for which forms of addictions and which types of addicts.

 

So, improve substance abuse disorders with mindfulness-based treatments.

 

So much of the internal narrative around cravings is not being able to handle it. What you get from mindfulness is the realization that you can deal with this, you can tolerate this.” – Nicholas Barr

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Korecki, J. R., Schwebel, F. J., Votaw, V. R., & Witkiewitz, K. (2020). Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Substance abuse treatment, prevention, and policy, 15(1), 51. https://doi.org/10.1186/s13011-020-00293-3

 

Abstract

Background

Substance use disorders are prevalent and returning to substance use (i.e., relapse) following treatment is common, underscoring the need for effective treatments that will help individuals maintain long-term reductions in substance use. Mindfulness-based interventions (MBIs) have been increasingly developed and evaluated for the treatment of substance use disorders. The aim of this article was to update a systematic review conducted by Li et al. in 2017 on the outcomes of randomized control trials of MBIs for substance use disorders. In addition, we provided a session-by-session examination of the most widely used MBI protocols.

Methods

We conducted a comprehensive literature search of the PubMed, PsycINFO, and Web of Science databases from January of 2016 through April of 2020. Studies were included based on the following criteria: 1) examined the effects of an MBI, 2) employed a randomized controlled trial design with repeated measures, including secondary data analyses of randomized controlled trials, and 3) enrolled participants seeking treatment for substance use disorders.

Results

The search identified 902 publications and 30 studies were eligible for inclusion and data extraction. MBIs appear to be as effective as existing evidence-based treatments for substance use disorders at reducing the frequency and quantity of alcohol and drug use, substance-related problems, craving for substance use, and at increasing the rate of abstinence.

Conclusions

Future directions include additional large scale randomized controlled trials, investigation of the most suitable settings and protocols, examination of patient populations that may benefit most from MBIs, and dissemination and implementation research.

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

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

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

 

Compulsive sexual behavior is frequently treated with psychotherapy, cognitive behavioral, therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. Indeed, mindfulness has been shown to be related to compulsive sexual behavior in men undergoing treatment for substance abuse. This suggests that further study of the relationship between mindfulness and compulsive sexual behavior with men and women should be investigated.

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

               

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

 

Abstract

Objectives:

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

Methods:

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

Results:

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

Conclusions:

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

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

 

Reduce Internet Addiction with Mindfulness

Reduce Internet Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravingsimpulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. It also has been found to be helpful in overcoming internet and smartphone addictions. But there is a need to further explore the effectiveness of mindfulness training on internet addiction.

 

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

 

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

 

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

 

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

 

So, reduce internet addiction with mindfulness.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Background

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

Aims

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

Methods

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

Results

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

Discussion

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

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

 

Meditation Alters a Variety of Biological Mechanisms and Improves Mental Disorders

Meditation Alters a Variety of Biological Mechanisms and Improves Mental Disorders

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

Conclusions

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

 

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

 

Improve Recovery from Substance Abuse with Rolling Mindfulness Training

Improve Recovery from Substance Abuse with Rolling Mindfulness Training

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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