Can Mindfulness Help With Addiction Recovery?

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Pre-pandemic studies indicated that more than 85% of individuals relapse and return to drug use within one year of treatment. With the convergence of a pandemic and an addiction epidemic, those attempting to recover from substance use disorders (SUDS) are more vulnerable to relapse than ever before. According to the Addiction Policy Reform (APF) Survey, 1 in 3 report changes in treatment or recovery support services due to the COVID-19 pandemic. More specifically, results show that more than 34% of the 1,079 respondents reported changes or disruptions in accessing treatment or recovery support services. Fourteen percent purported that they were unable to receive their needed services, and 2% say they were unable to access naloxone services.

To make matters worse, government funding for addiction treatment programs has been slashed throughout the United States due to the pandemic's national economic toll. Cutting the budgets for addiction treatment programs during the worst pandemic in 100 years is incomprehensible, inhumane, and shines an unignorable spotlight on American society's ignorance, condemnation, and blatant disregard for those afflicted with addiction. According to writer and editor Kristina Ackerman of Americanaddictioncenters.org, relapse is exceptionally dangerous for substance abusers who have abstained from drug use for extended periods due to the loss of tolerance for the drug of abuse. She states, "substance abusers will often attempt to consume the same amount they were accustomed to consuming during the height of their abuse which could result in overdose and even death."

Know Your Triggers

Of the APF survey respondents, 75% reported emotional changes since the beginning of the pandemic, especially increased worry (62%), sadness (51%), fear (51%), and loneliness (42%). Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), noted, "These emotions increase the risk for relapse, and unfortunately, circumstances since the pandemic has made peer support, for instance in 12-step meetings and similar groups, much more difficult."

Craving is defined as the experience of an urge or desire to use substances, which has been identified as a substantial predictor of substance use, substance use disorder, and relapse following treatment for substance use. Higher craving levels during abstinence and outpatient treatment are known to predict relapse and return to drug use. Cravings can happen abruptly and are frequently brought on by "triggers." Most triggers are emotional or situational and associated with memories of previous substance use.

Addictioncenter.com notes several other emotional and environmental triggers as well as warning signs for relapse. Notice how many are outcomes of the pandemic, i.e., loss of a loved one, boredom, etc.

• Emotions that stimulate drug-seeking behavior (stress, anger, fear, frustration, guilt, anxiety, depression, loneliness)
• Friends, locations, or events that remind the individual of using
• Exposure to drugs of abuse
• Seeing or sensing an object of addiction (e.g., watching a beer commercial)
• Positive emotional states (having fun and wanting to enhance the feeling)
• Using other substances
• Loss of a loved one
• Conflict with others
• Health problems
• Major financial changes
• Boredom

Warning Signs of Potential Relapse

• Overconfident attitude
• Self-pitying attitude
• Dishonesty
• Hanging out with people from drug use days
• Changes in personal hygiene, sleep, or appetite
• Sudden changes in routine and irresponsible behaviors (skipping school, work, or appointments)

What Is Mindfulness-Based Relapse Prevention (MBRP)?

Mindfulness-Based Relapse Prevention, or MBRP, was created in 2010 at the Addictive Behaviors Research Center at the University of Washington. MBRP combines mindfulness and cognitive-behavioral relapse prevention skills to help individuals maintain sobriety, prevent relapse after having undergone initial SUDS treatment programs. Why incorporate mindfulness? The significance of increasing mindfulness may be best captured in a quote by the existential psychotherapist Viktor E. Frankl, "Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom." Mindfulness gives us the "psychological space" to pause, notice and observe urges and cravings. Giving us the advantage of time and simultaneously the opportunity to make a different decision, possibly even a healthier decision. The even better news is that mindfulness training can change the brain, making people less reactive and better able to regulate their emotions.

The Four Primary Goals of MBRP

These are:

1. Develop awareness of personal triggers and habitual reactions and learn ways to create a pause in this seemingly automatic process.

2. Change relationship to discomfort, learn to recognize challenging emotional and physical experiences, and respond to them in skillful ways.

3. Foster a nonjudgmental, compassionate approach toward ourselves and our experiences.

4. Build a lifestyle that supports both mindfulness practice and recovery.

Can mindfulness really help prevent relapse?

In a 2017 study, researchers found that practicing mindfulness in MBRP may reduce the link between craving and substance use and increase resilience for relapse. In 2014, a randomized control trial (RCT), the gold standard trial for evaluating the effectiveness of interventions, was conducted by Bowen and colleagues. The study investigated how effective the Mindfulness-Based Relapse Prevention program would be compared to a standard relapse-prevention program and a conventional 12-step program. Six months following the intervention, the mindfulness-based program and the traditional relapse-prevention program were more successful at reducing relapse than the 12-step program. One year later, the mindfulness-based program proved to be more effective than the other two in reducing drinking and drug use.

Mindfulness Essential Reads

Study Shows That Brief Mindfulness Training Helps

How to Encourage Our Kids to Eat Greens

2 MBRP Techniques to Try

Urge Surfing

Restorationtherapy.com defines and outlines how to "urge surf" succinctly. "Urge surfing involves the understanding that urges are simply impulses connected to old habits. Urges can be observed, examined, and felt, recognizing the feelings and sensations they bring you. The technique teaches us that they don't have to be "given in to" rather can be welcomed and felt as surf the feelings they give you. After 20 or 30 minutes, urges typically subside on their own."

How to Urge Surf

Urge surfing can be done in five simple steps.

1. Recognize physical sensations
2. Focus on those sensations
3. Focus on your breathing
4. Focus again on your body and physical sensations
5. Stay present in the moment, taking it all in

Try a 3-Minute Urge-Surfing Meditation

Nonjudgmental Approach

It's well-documented that judgment of emotions intensifies emotions. Fostering a nonjudgmental, compassionate approach toward yourself is essential to maintain sobriety.

2-Minute Watch

Interested in MBRP for yourself or a loved one?

MindfulRp.com offers audio guidance resources and an MBRP therapist directory here.

You can do hard things,

Dr. K

If you or a loved one are struggling with addiction or addictive behaviors, please reach out to SAMHSA's National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

To find a therapist, please visit the Psychology Today Therapy Directory.