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 One year after treatment for substance abuse, far
fewer participants who got relapse-prevention training including
mindfulness techniques had used drugs or alcohol compared to those
given relapse-prevention therapy alone or a standard 12-step
program.
"Addiction is really a tough one," Sarah Bowen told Reuters Health.
"The relapse rates remain really high even after decades of work by
the best scientists out there. We need to keep looking at more
options."
Bowen, from the Center for the Study of Health and Risk Behaviors at
the University of Washington in Seattle, led the new research.
"We need to keep looking at innovative approaches of addiction
treatment," she said. "I don't want to say mindfulness is better for
everyone, but it's another option."
Bowen and her colleagues write in JAMA Psychiatry that about 11
percent of people in the U.S. with substance abuse problems seek
treatment every year, but between 40 percent and 60 percent relapse.
Relapse prevention therapies are meant to help people avoid falling
off the wagon after they're released from an intensive treatment,
such as a rehabilitation program, or "rehab."
Traditional approaches to reducing a person's risk of using drugs
and alcohol again include a 12-step program based within a support
group structure that emphasizes abstinence.
Another popular approach to relapse prevention is based on
cognitive-behavioral therapy, which teaches people how to confront
and cope with particular situations, such as refusing drugs and
alcohol.
The mindfulness-based approach builds on that kind of relapse
prevention program by also teaching self-awareness through
meditation. Those techniques allow people to understand what drives
cravings and better deal with the discomfort they can create.
Another recent study determined that mindfulness meditation helped
stave off chocolate cravings, for example, by letting people
distance themselves mentally from the feeling of craving (see
Reuters Health story of March 13, 2014 here: http://reut.rs/1m3Jr2P).
For the new study, Bowen and her colleagues recruited 286 people who
had successfully completed substance abuse treatment and randomly
assigned them to participate in one of three treatments for eight
weeks.
One group did a standard 12-step program, another group did a
cognitive-behavioral-based relapse prevention program and the third
group did a program combining relapse-prevention with mindfulness
techniques. All the therapies were administered through group
sessions.
The researchers then followed the participants for 12 months to see
how many used drugs or alcohol.
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After three months, participants in all three groups were performing
similarly. But after another three months, both of the relapse-prevention groups
began performing better than the 12-step program participants. At the one-year
mark, the mindfulness-based relapse-prevention therapy outperformed the other
two approaches.
About 9 percent of the participants in the mindfulness group
reported drug use after a year, compared to about 14 percent in the
12-step program group and 17 percent in the traditional
relapse-prevention group.
Only about 8 percent of the participants in the mindfulness group
also reported heavy drinking after a year, compared to about 20
percent in the other two therapy groups.
"Adding these skills to the training program clearly left a mark
even if it wasn't discernible right away," Dr. Elias Dakwar, who was
not involved in the new study, told Reuters Health.
Dakwar is a specialist in mindfulness training and substance abuse
in the Division of Substance Abuse at Columbia Psychiatry in New
York.
"What the finding suggests to me is that adding these mindfulness
skills to the relapse platform has a measurable effect 12 months
later," he said.
Bowen said it could be that the mindfulness meditation techniques
are more applicable and adaptable than the techniques taught in
traditional relapse prevention.
"In a relapse prevention group the skills are very specific," she
said. "I think sometimes what happens is the skills are so specific
to certain situations they may not generalize to what happens when
you're out of treatment."
"In the mindfulness group, the practices that are learned are
generalized to everything," Bowen added. "It's about paying
attention to your experiences."
She cautioned, however, that not everyone did great in the
mindfulness group, and the findings need to be confirmed by more
studies.
"I think it's very exciting to see results like this a year out, but
every study has caveats," Bowen said. "As with all science, we need
to look further and be careful of absolutes." ___
Source: http://bit.ly/OFd9Nj
JAMA
Psychiatry, online March 19, 2014.
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