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Mindfulness

Mindfulness Practice Reduces Relapse Risk

Mindfulness practice is an important part of successful relapse prevention

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This is the fifth post in a series on non-pharmacologic approaches for alcohol and drug abuse. Previous posts included a general overview of alternative and integrative treatments of substance abuse, a discussion of research evidence supporting the use of weak electrical current (neurelectric therapy) for managing symptoms of opiate withdrawal, and a review of research findings on herbals and other natural supplements for managing craving and withdrawal from alcohol and drugs. This post is offered as a concise review of mindfulness training for relapse prevention.

Mindfulness training and meditation reduces alcohol and drug relapse risk

Many studies show that regular mindfulness training can modify these neural mechanisms resulting in decreased substance use and lower risk of relapsing. Research findings suggest that substance abuse is related to abnormal functioning of brain mechanisms underlying reward learning and executive functioning (Priddy 2018).

Individuals who successfully avoid relapse while participating in a 12-step program frequently experience increases in spirituality (Mathew 1996). Mindfulness training and meditation are standard offerings in relapse prevention programs. Transcendental meditation may be especially effective in reducing the risk of relapse in abstinent alcoholics (Alexander 1994). Mindfulness training and spirituality are important parts of 12-step programs for relapse prevention of alcohol, tobacco and narcotic abuse, however evidence does not support any particular spiritual or mindfulness practice over any other. 12-step programs that emphasize a religious or spiritual philosophy may be more effective compared to spiritually neutral programs (Muffler 1995) (Please see full citation information below).

Two recent systematic reviews concluded that mindfulness-based interventions were successful for reducing use of several substances of abuse including alcohol, methamphetamine, cocaine, alcohol, marijuana, cigarettes and opiates while often improving mood (Sancho 2018; Chiesa 2014). The paper by Sancho et al found that individuals who engage in regular mindfulness practice while receiving treatment as usual (i.e., cognitive behavioral therapy (CBT) and medication management), report lower relapse rates compared to individuals using mindfulness or conventional approaches alone.

Bottom line

There is considerable evidence that a regular mindfulness practice helps individuals with substance use problems to use less, and reduces the risk of relapse in abstinent individuals. Recovering alcoholics and addicts should be encouraged to pursue a mindfulness practice consistent with their beliefs and to consider attending a spiritually focused support group that combines conventional approaches such as cognitive-behavioral therapy with mindfulness.

To find out more about non-pharmacologic approaches for relapse prevention check out my book "Alcohol and Drug Abuse: The Integrative Mental Health Solution."

References

Muffler J Langrod J Larson D There is a balm in Gilead: religion and substance abuse treatment In: Lowinson J.H. Ruiz P, Milman R Langrod J Eds Substance abuse: a comprehensive textbook, 2nd edition, Baltimore, MD Williams and Wilkins 584-595, 1991.

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About the Author
James Lake, MD

James Lake, M.D., a clinical assistant professor at the University of Arizona College of Medicine, works to transform mental health care through the evidence-based uses of alternative therapies.

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