Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Abstract

Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.

The effect of tai chi and Qigong exercise on depression and anxiety of individuals with substance use disorders: a systematic review and meta-analysis

“…Possible mechanisms of Tai Chi and Qigong exercise on depression and anxiety among individuals with substance abuse disorder can be explained from the following perspectives. First, Tai Chi and Qigong exercise can decrease physiological arousal and promote relaxation, which, in turn, mitigates the anxiety sensitivity and the possibility of relapse [60]. Second, mindful concentration emphasized by Tai Chi and Qigong exercise strengthens the brain circuits involved in the regulation of prefrontal cortex.…”

“…Second, mindful concentration emphasized by Tai Chi and Qigong exercise strengthens the brain circuits involved in the regulation of prefrontal cortex. The repeated activation of prefrontal cortex, that occupies neurocognitive resources, may mediate the "pleasure dissonance" and facilitate the automation of cognitive control of drug addicts [60]. Third, reconstruction of reward system theory claimed that the perception and sensation of happiness experience brought from practicing Tai Chi and Qigong, as an alternative where awards were gained spontaneously, may reconstruct the source of rewarding and thereby resolve the "pleasure dissonance" [61].…”

Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial

“…Mindfulness-based interventions have been proposed as adjunctive treatments targeting relapse prevention in substance use disorders (Bowen, Chawla, & Marlatt, 2010). Improved emotion regulation, reduced stress reactivity, and decreased risk of relapse in high-risk situations have been hypothesized and documented as possible mechanisms, through which mindfulness-based interventions may impact substance use-related outcomes (Garland, Gaylord, Boettiger, & Howard, 2010;Koob et al, 2014;Kober, Brewer, Height, & Sinha, 2017;Li et al, 2017;Priddy et al, 2018;Davis et al, 2018). Several studies of mindfulness-based interventions, including Mindfulness-Based Relapse Prevention (MBRP), for a broad spectrum of substance use disorders have shown beneficial findings for reducing relapse risk, frequency and amount of substance misuse, craving, drug and alcohol-related consequences, mental health symptoms, and physical health problems (Bowen et al, 2009;Bowen et al, 2014;Witkiewitz & Bowen, 2010;Witkiewitz, Warner, et al, 2014).…”

Integrative Medicine: A Health Paradigm of the Future

“…136 It is particularly useful in handling ailments in which obesity plays a significant role, 137 improving quality of life in elderly breast cancer patients, 138 and as effective therapy of cardiovascular disease, 139 and chronic low back pain. 140 In association with yoga or not, mindfulness meditation showed efficient results when used in substance abuse disorders and preventive relapse, 141 other intervention such as relaxation with or without aromatherapy are also useful, particularly in handling fatigue in patients undergoing hemodialysis, 142 as well as transcendental meditation in prevention and treatment of cardiovascular diseases. 143 Bach floral remedies.…”