Mindfulness for Substance Use Disorders? Absolutely

The great news for people struggling with substance use disorders (SUDs) and their loved ones is this: Therapy works.

As one of the three pillars of SUD treatment—the others being medication (naltrexone, buprenorphine, methadone, etc.) and social supports such as counseling and peer meetings—psychotherapy or talk therapy significantly increases a person’s chances of finding long-term sobriety. Reams of research studies and countless real-world experiences back this up.

But which therapy works best? Several have been scientifically proven to work, so it may come down to individual preference. The top evidence-based SUD therapies include dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), motivational interviewing, contingency management therapy, and cognitive behavioral therapy (CBT).

That last one, CBT, may be the most successful and popular of all the new-breed therapies being used to fight SUD. It has done wonders.

Then there's the 2,500-year-old therapy option

Mindfulness is a state of mind and way of understanding the world that is reached through the practice of meditation. Mindfulness is also showing great success in addiction treatment.

Here's proof: Originating out of Buddhist teachings around the year 500 BCE, mindfulness actually performed better than CBT in 2016 published research comparing the two therapies in a small group of people with SUD and co-occurring psychiatric disorders.

The study researchers wrote that their “pragmatic trial represents the first head-to-head comparison of [mindfulness] against an empirically supported treatment [CBT] for co-occurring disorders.”

They concluded that mindfulness “as an integrated therapy designed to bolster self-regulatory capacity may hold promise as a treatment for intersecting clinical conditions.”

Hold promise it does. We teach mindfulness to our residents at the addiction treatment clinic in Jacksonville, Florida, where I am the chief medical officer. Residents generally do very well with this therapy.

Mindfulness for SUDs: Further scientific proof

As defined by the American Psychological Association, mindfulness is the “awareness of one’s internal states and surroundings. Mindfulness can help people avoid destructive or automatic habits and responses by learning to observe their thoughts, emotions, and other present-moment experiences without judging or reacting to them.”

For anyone who knows how addiction works, that definition of mindfulness makes it clear how well-suited it is as a therapy for SUDs. The science backs that up:

1. In a 2018 analysis published in Substance Abuse and Rehabilitation, researchers cited studies showing that mindfulness is particularly effective for SUD relapse prevention.
2. Another 2018 meta-analysis, this one published in Clinical Psychology Review, found consistent evidence that mindfulness helped people with addictive disorders.
3. And in 2021, a meta-review in Behavioral Sciences found that mindfulness was especially effective at reducing cravings, decreasing frequency of use, and improving depressive symptoms in people with SUDs.

Further mindfulness benefits for people with SUDs

As I mentioned above, we offer mindfulness/meditation training to the residents at our center, and we hear from them how it helps strengthen their recoveries.

Residents say they are

• Less reactive to adverse thoughts, conversations, and situations
• Better able to regulate emotions
• Less judgmental of themselves, including regarding perceived past transgressions
• Better able to objectively examine fears, anxieties, and reactions
• More aware of triggers and their accompanying reactions
• Better able to live with and make peace with anxieties rather than escaping from them at all costs

Final thoughts on mindfulness as therapy for SUD

One of the truly game-changing benefits of mindfulness training is that it can help people be more thoughtful, observant, and tolerant—about themselves, the people around them, and the world in general.

That is such an important benefit for people in addiction recovery.

Mindfulness Essential Reads

Study Shows That Brief Mindfulness Training Helps

How to Encourage Our Kids to Eat Greens

People with SUDs tend to be judgmental—especially toward themselves. They’re sometimes consumed with guilt, shame, and self-directed anger.

That destructive thinking makes recovery more difficult. It holds people back because they spend so much time beating up on themselves.

Attaining mindfulness can be an amazing shift for a person in recovery who has been stuck in a state of self-loathing. That change is a magical thing to witness.