Editorial Mindfulness-Based Therapies for Substance Use Disorders: Part 2

This is the second of two Special Issues of Substance Abuse devoted to mindfulness meditation based interventions for substance use disorders (SUDs) and their spectrum. The first part was published as the December 2009 issue of Substance Abuse (1). It featured five articles describing results of studies evaluating mindfulness based interventions: a systematic review of literature on this topic, by Zgierska et al. (2), and four original research papers by Bowen et al. (3), Brewer et al. (4), Vidrine et al. (5) and Waters et al. (6). Combined, findings from these pilot-level studies suggest that mindfulness meditation based interventions may be efficacious for SUDs.

This second Special Issue further adds to the mindfulness literature by presenting results of five additional studies that evaluated effects of mindfulness-based interventions in a range of substance-abusing client populations. Papers in this issue illustrate the ways in which mindfulness practice has been combined with other behavioral treatments and/or adapted to meet the needs of specific client populations.

In their study: "Linguistic analysis to assess the effect of a mindfulness intervention on self-change for adults in substance use recovery," Liehr and colleagues used an innovative method to measure self-change in participants in a therapeutic community who received Mindfulness Based Therapeutic Community (MBTC) versus treatment as usual. They used a linguistic analysis method applied to participant-written stories of stress and found that the MBTC group used fewer negative words than the control group over all time points.

Britton and colleagues, in the study: "The Contribution of Mindfulness Practice to a Multicomponent Behavioral Sleep Intervention Following Substance Abuse Treatment in Adolescents," found that mindfulness practice was associated with improved sleep, psychological health and reduced substance use.

In "Psychosocial Treatment for Methamphetamine Use Disorders: a preliminary randomized controlled trial of cognitive behavior therapy (CBT) and acceptance and commitment therapy (ACT)," Smout and colleagues found that, although ACT did not improve treatment outcomes or attendance compared to CBT, it may be a viable therapeutic alternative for methamphetamine use disorders.

In their article, "Development of an Acceptance-based Coping Intervention for Alcohol Dependence Relapse Prevention," Vieten and colleagues describe the development and pilot-testing of a mindfulness-based relapse prevention intervention for alcohol dependent individuals who stopped drinking within the past 6 months.

Amaro and colleagues, in their study: "Addiction Treatment Intervention: An Uncontrolled Prospective Pilot Study of Spiritual Self-Schema Therapy with Latina Women," noted high rates of intervention acceptability, and positive changes in outcomes relevant to HIV prevention and recovery from addiction.

Although conclusive data for mindfulness meditation based interventions as therapies for SUDs are lacking, the preliminary evidence reported in these and prior studies suggests their efficacy. The promise of mindfulness based therapies is supported by the consistency of positive results demonstrated across different study designs, intervention modalities, subject populations and addictive disorders treated (2). Additional support for the potential efficacy of these interventions in SUDs can be drawn from the results of studies of other clinical conditions; mindfulness based therapies have been shown effective or potentially effective for a variety of medical and mental health disorders, including stress, anxiety, depression, emotion dysregulation, avoidance coping,(7–12) all known risk factors for relapse in SUDs (13,14). In this context, mindfulness meditation based interventions may be particularly helpful for patients with co-occurring substance use and mental health disorders ("dual diagnosis").

In addition, mindfulness based interventions appear safe, satisfying to clients and may have long-lasting effects in the context of continued meditation practice (2,7) – all vital qualities of an "ideal" treatment. The success of mindfulness based interventions and the unsatisfactory outcomes of many existing therapeutic modalities indicate that the time is right for, rigorous assessment of mindfulness based therapies for addictive disorders.