Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis

by | Addiction

http://journals.lww.com/journaladdictionmedicine/Fulltext/2017/10000/Mindfulness_based_Relapse_Prevention_for_Substance.8.aspx

Grant, Sean DPhil; Colaiaco, Benjamin MA; Motala, Aneesa BA; Shanman, Roberta MS; Booth, Marika MS; Sorbero, Melony PhD; Hempel, Susanne PhD

Objectives: Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs.

Methods: We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results: We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46–1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI −0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD −0.09, 95% CI −0.39 to 0.21, low QoE), anxiety symptoms (SMD −0.32, 95% CI −1.16 to 0.52, very low QoE), and mindfulness (SMD −0.28, 95% CI −0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD −0.13, 95% CI −0.19 to −0.08, I2 = 0%, low QoE) and negative consequences of substance use (SMD −0.23, 95% CI −0.39 to −0.07, I2 = 0%, low QoE). We found negligible evidence of adverse events.

Conclusions: We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

Comment;

“Mindfulness” has a long-established mantra in the community of therapists.  It’s good to see an unbiased review of how it’s actually working out.

Not so well.

Acupuncture/Acudetox however does have better results; it’s amazing what this form of therapy does to the recipient!  I’ve had folks come into my office who were so agitated that they “just need to kill something!”.  Within 5 minutes they’re so calm and relaxed they look like “road kill” splayed out in a chair totally relaxed.  Folks abuse drugs to change how they feel, to “numb out” and relieve their emotional distress/pain.  Rebalancing the “Chi” or “life-force” or however it is that acupuncture really works (“western, modern” medicine cannot describe or explain it), there’s no arguing with success!!

Dr. Raymond Oenbrink
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