MINDFULNESS BASED RELAPSE PREVENTION FOR ADULT SUBSTANCE ABUSERS

The role of mindfulness (defined as the gentle effort to be continuously present with experience) based treatment approaches for psychiatric disorders seems to be increasing. I have previously blogged about the benefit of mindfulness approaches to reduce stress in elementary age children.  Brown, et al. JAMA Psychiatry 2014 Mar 19 reported on their randomized clinical trial evaluating the benefit of 8 weekly group sessions of mindfulness based relapsed prevention (MBRP)compared to COGNITIVE-behavioral relapse prevention (RPT), and treatment as usual (TAU) that included a 12 step program.  Studies have shown that 40-60% of people with substance use disorders (SUD) relapse by 1 year after treatment. The studies cite interactions between personal motivation, coping skills, peer influences, and substance availability as leading to relapses.  Relapse prevention programs focus on identifying situations that trigger craving and how to avoid them while enhancing skills to help avoid substance use. 286 people with SUD's ( 74% male; 39% ethnic minority and average age =38) we're randomized to participate in one of the three treatment groups.  The focus of RPT and TAU was on avoidance of high risk situations and reducing disphoria that can both lead to relapse by providing support and cognitive restructuring.  The MBRP treatment teaches tolerance of dysphoric feelings and the different setbacks that life presents, reducing the need to use substances to reduce stress.  MBRP also encouraged emotional flexibility ways to accept daily problems.  After three months there was no difference in outcomes across the three groups.  After 6 months, both MBRP and RPT showed significantly fewer relapses.  After one year, only MBRP was associated with significantly fewer relapses.

So it seems that an ancient (2500 year old) meditative practice that has been updated in the last century is now helping people of all ages to reduce their stress level and learn new and positive coping skills...all by calmly, with slow even breaths, staying in the moment and experiencing life without judgment or anxiety.  Give it a try.