Addiction is tough. I have first-hand experience of the complexities and challenges faced when dealing with addiction, and believe me, there is a lot to consider.

The cravings, thought processes, mind chatter, desires and genuine beliefs that you need to get more of a substance just to feel normal can outweigh and override all other rational thinking and logical thought processes. The mind can run away on random tangents and create stories of past and present, legitimately convincing itself that it needs more: just one more time and then everything will be fine, then I’ll stop.

But we all know that this won’t be that last time, and tomorrow a similar chatter in the mind will occur again.

And then there is the impact on family and friends. Dealing with a close family member who is battling an addiction at its most raw level can be absolutely devastating. The lies, attacks, manipulation and genuine lack of integrity for all of those close to them can be literally unfathomable. Seeing flesh and blood turn into a dark stranger is heartbreaking.

So can mindfulness help people to break free from addictive behaviours?

Science, addiction and mindfulness

This is a question that that has been increasingly asked in the scientific community and there is no wonder as to why. It is clear that there is a definite problem relating to substance misuse that does not appear to be going away any time soon.

But why do people become addicted to substances?

Why do they need to escape reality?

Is there something fundamentally wrong with society or is it more a case of an ineffective or incomplete approach to treatment?

Current treatment plans are ineffective

Prescribing drugs to take people off drugs seems to be missing the point. What really needs to be explored is the deep underlying cause that leads people to engage in this type of behaviour, and what we need to do to help bring them back.

Mindfulness has been proposed as a promising treatment approach to help people reduce substance misuse, for everything from nicotine or alcohol addiction through to narcotics and ice (crystal methamphetamine).

The mechanism of action (or the way it works) involves helping people to connect to a greater purpose and facilitating meta-cognition (awareness of ones thoughts), thereby enabling a greater awareness of stream of consciousness. In other words, help people to accept but not engage in the chattering mind.

As described by Garland et al. (2014), mindfulness may reduce cravings by increasing awareness of substance related urges, enabling people to reorient their attention to more health-promoting thoughts and reduce the potential for stress induced substance relapse.¹

A recent systematic review investigating the effects of mindfulness for substance misuse reported that the global incidence for illicit drug use is rising and effective treatments are urgently required.²With relapse rates as high as 60% in the year following conventional evidence-based treatments, it is apparent that the current approach is not effective and clearly something is not quite right.

So what is the current approach missing and how can a solution be incorporated to help effectively fill the gap?

Mindfulness as a treatment for addictive behaviours

The aforementioned systematic review examined 42 studies that investigated a range of different substance misuse presentations including alcohol, nicotine, cocaine, prescription opioids and heroin. Study interventions explored a variety of mindfulness treatments or options, and their impacts on diverse personal backgrounds and population groups.²

Programs discussed in the study that I am familiar with and have experienced include the 8-week mindfulness-based stress reduction (MBSR) course and Vipassana silent meditation retreats (both of which I highly recommend, possibly for different people at different times in their lives), as well a number of addiction interventions that include Mindfulness-Based Relapse Prevention, Mindfulness-Oriented Recovery Enhancement and mindfulness training for smoking cessation.

Studies consistently showed positive findings regarding reducing the amount and frequency of substance misuse, reducing cravings, reducing withdrawal symptoms and reducing substance use-related consequences (such as legal complications).

Additionally, participants receiving mindfulness treatment reported greater reductions in psychiatric distress, reduced negative emotions and moods, lowered impact of stress and a significant increase in emotional regulation.

As numerous factors need to be taken into consideration when working through addiction, the research seems to point towards mindfulness offering some promising positive benefits.

Mindfulness, connection and community

The truth is, though, that there is no one size fits all approach, and as with all treatment interventions, it does not come without limitations.

The main goal is to support both the mind and body to help avoid the potential for relapse and provide suitable support networks to help transition through these difficult times.

Factors such the frequency and severity of substance use, intensity of craving for substances, social networks (i.e. the people you are surrounded by) and severity of stress all play a significant role in how successful this process is.

At the core of the solution, I believe everyone has a desire to feel connected to something bigger and feel a part of a life with purpose. Current evidence-based treatment appears to neglect this fact and focus on one tiny part of the problem at hand.

As the science of addiction treatment continues to evolve and best practices advance, the future of mindfulness intervention is likely an important part of a bigger puzzle.

Hopefully this is the missing link that helps provides contentment with what is, and makes reality seem bearable, hopeful and exciting. As it is.

References and further reading

1. Garland EL, Froeliger B, Howard MO. Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Front Psychiatry. 2014;4(JAN):1-16. doi:10.3389/fpsyt.2013.00173.
2. Li W, Howard MO, Garland EL, McGovern P, Lazar M. Mindfulness treatment for substance misuse: A systematic review and meta-analysis. J Subst Abuse Treat. 2017. doi:10.1016/j.jsat.2017.01.008.