Could mindfulness be an effective treatment for opiate abuse and addiction?
Opioid abuse is a widespread problem. Due to the drugs’ effectiveness in relieving pain, large swathes of the population receive a prescription for opiates at one time or another.
Nearly one third of Americans suffer from chronic pain. Vicodin, oxycodone, morphine, codeine, and Hydrocodone products are the most commonly prescribed for a variety of painful conditions.
Regrettably, physical dependence or addiction can develop when opioids are used regularly or long term. Abuse can lead to severe respiratory depression and death.
Standard treatment approaches for opioid addiction are based on research about treating heroin addiction. Medications, such as Naltrexone, methadone and Buprenorphine are common treatments for opiate addiction, but all three treatment medications are addictive to varying degrees, or carry some side effects. Therefore, researchers have been testing another treatment for opioid addiction: mindfulness.
Mind Your Treatment
Researchers at the University of Utah, led by Eric Garland, found that mindfulness treatment brought about a 63 percent reduction in opioid misuse. At the same time, conventional support groups delivered only a 32 percent reduction in misuse. He and his colleagues reported their findings in the February 2014 issue of the Journal of Consulting and Clinical Psychology.
The new treatment, called MORE (Mindfulness-Oriented Recovery Enhancement), teaches participants novel responses to stress, pain, and cues to take more opioids. There are three components to the method: mindfulness training, reappraisal and savoring.
Mindfulness, a concept that stems from Eastern religions, is about training one’s mind to pay attention to cues and regulate automatic habits. Reappraisal refers to reframing, or viewing a stressful event from a positive, growth-promoting perspective. Savoring means learning to attend to positive events in an effort to expand sensitivity toward experiences that are naturally rewarding, such as relationships. The results show that MORE increased their awareness of opioid cravings, and helped them to determine the difference between cravings and a legitimate need for pain relief.
Drug Abuse: Pay Attention to Avoid Cravings
Garland’s study builds on the findings of Katie Witkiewitz, a researcher at the University of New Mexico. In a 2013 study, she and her colleagues also studied the effects of mindfulness on craving, which is the subjective experience of an urge to use substances. Not surprisingly, craving is a significant predictor of substance use, abuse and relapse.
Witkiewitz and her colleagues were following up on a 2009 study led by Sarah Bowen, PhD. Bowen and her colleagues were the first to study the effect of MBRP (mindfulness-based relapse prevention) on cravings. For the study, 168 adults with substance use disorders who had recently completed drug treatment participated in an 8 week outpatient MBRP program.
The participants reported reduced cravings, increases in acceptance and greater acting with awareness, both immediately after treatment and four months after treatment had ended.
Wikiewitz and her colleagues sought to understand how mindfulness reduces cravings for drugs. They learned that when participant in MBRP reported increased self-acceptance, awareness of situations, and non-judgment, they reported lower levels of craving following their treatment. In other words, key components of mindfulness helped reduce their cravings for substances. On the basis of this study, treatment professionals could incorporate these aspects of mindfulness into the treatment of opioid users. They can be taught to notice their triggers and cravings, and to foster a nonjudgmental, kind approach toward themselves and their experiences.
Avoiding Opioid Addiction: Is Mindfulness Superior?
Is mindfulness the answer to opioid addiction? Or are the standard treatments preferable? The answer is probably both, depending upon the individual receiving the treatment. There are many treatment methods, some of which seem more appropriate for the needs and goals of any given person. The U.S. Department of Veteran Affairs, for example, takes a stepped care approach to substance abuse. The first principle of stepped care is that treatment should be individualized with regard to the client’s needs and problems. Fortunately, many researchers are concerned with the issue of substance abuse. Novel treatment methods, such as mindfulness, will certainly be better suited to some people more than to others.