Can Mindfulness Training Reduce Stimulant Relapse Rates?

A recent study suggests that mindfulness training can be used to reduce relapse rates related to cocaine or methamphetamine addiction in persons diagnosed with depression or anxiety.


What Are Stimulants?

Stimulants are drugs that increase the body’s alertness and energy levels. They also increase blood pressure and heart rate, constrict blood vessels, and open up the airways in the lungs, increasing the respiratory rate. A doctor might prescribe stimulant drugs to treat certain medical conditions, such as ADHD, narcolepsy, or depression.


Problems with Stimulant Use

While it is acceptable to use stimulants for a number of health conditions, many people perceive these drugs to be safe for general use and are beginning to use them without a prescription. Drugs like Ritalin and Adderall are being used more and more frequently to induce euphoria or increase performance. These drugs are dangerous when used for nonmedical purposes because they can lead to addiction, major cardiovascular events, and psychosis.


Thinking on the beach


What is Mindfulness?

Mindfulness training teaches you to actively evaluate your present situation, thoughts, and feelings from a distance without passing judgment. Mindfulness is a state of being in which you do not think about the past or present, and instead live actively in the moment.


Mindfulness-Based Relapse Prevention Study

A recent study conducted at the University of California, Los Angeles, compared mindfulness-based relapse prevention (MBRP) and health eduction (HE) as treatments in 63 patients with addictions to stimulant drugs. During the first four weeks of the treatment, addictions were managed with only contingency management interventions, in which the participants received rewards for negative urine samples. After four weeks, the participants were randomized and assigned to one of the two treatment groups (MBRP or HE), while continuing the contingency management program.

At the end of 12 weeks, the people in the mindfulness-based treatment group had a lower relapse rate than the people in the health education group; that is, 87% (27 out of 31) of the participants in the MBRP group and 62% (20 out of 32) of the participants in the HE group were still not using stimulants. When looking at participants who only struggled with mood and anxiety disorders, the difference was even greater. Severity of depression was also reduced among those in the MBRP group.


What Are the Current Treatments for Stimulant Use?

There are currently no approved pharmacotherapies for treating additions to illicit or prescription stimulant drugs (Adderall, Ritalin, etc.).

Persons wishing to quit these drugs should see an addictionologist for treatment. Quitting usually involves slowly tapering off the substance and managing withdrawal symptoms. A doctor is needed to help the person manage severe symptoms with other prescription medications.

The two recommended treatments for stimulant use are behavioral-based therapies: contingency management and cognitive-behavioral therapy.

With contingency management, the patient is given vouchers in exchange for giving negative urine test results. The vouchers can be traded in for items (like food and movie tickets) that promote healthy, drug-free living. In the beginning, the value of the vouchers is small, but as a person progresses and goes longer periods without drug use, the value of the vouchers increases.

With cognitive-behavioral therapy, a psychologist works with the person addicted to stimulants to understand the thoughts and emotions behind drug use and determine alternative behaviors that the person can use to deal with their stress. Two Dreams utilizes cognitive-behavioral therapy as opposed to contingency management treatment.


Cognitive-Behavioral Therapy and Mindfulness

Mindfulness and cognitive-behavioral therapy both involve evaluating the thoughts and feelings concerning a present dilemma but go about it in different ways. With cognitive-behavioral therapy, one works on rejecting their negative beliefs; with mindfulness therapy, one works on not creating negative beliefs in the first place. Because cognitive-behavioral therapy is useful in treating drug addiction, there is a reason to believe mindfulness might also be a valuable tool. Some consider mindfulness to be a better strategy because one works on the state of “being” a positive person.


Therapy session


In cognitive-behavioral therapy, the psychologist uses discussion to help clients evaluate their thoughts and feelings and assists in reinterpreting situations. For example, a client might assume their boss did not respond to an email because they don’t like them. The therapist would train the client to realize that their thoughts are untrue and negative, and that they should consider more realistic reasons why the boss didn’t answer, like genuine schedule conflicts. Clients learn to reject their primary negative thoughts and work past them in ways that don’t involve self-destructive behavior such as drug use or lashing out irrationally.

Mindfulness usually involves the person using meditation to examine their thoughts, feelings, and situational cues in order to avoid passing judgment and formulating ideas on things they don’t know. For example, in the previously mentioned scenario, since the boss never gave any concrete evidence of disapproval, the “hatred” is not part of reality and should not be considered.

Incorporating mindfulness into cognitive-behavioral therapy may prove to be helpful for people looking to manage their drug addictions more successfully. The recent report from UCLA suggests it could be especially helpful for reducing stimulant relapse rates in people with anxiety and depression. Might mindfulness be useful in treating people with depression and other drug addictions? More research is needed to be sure.


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