Mindfulness Based Relapse Prevention is an effective and evidence based intervention for addiction relapse prevention. Statistics indicate that conventional treatment for addictions help approximately 33 percent of people to overcome substance use and have a 70 percent relapse rate. Yet these treatments are considered to be the treatment of choice by the National Institute of Drug Abuse.
Having known many family members friends, and clients who have struggled with addictions, I’m a big proponent of mindfulness training for addictions, and I offer mindfulness training for addiction relapse prevention to my clients.
Our brains are evolutionarily designed to learn and remember in order to support our survival. The brain operates on a reward-based learning system that is very primitive: trigger, behavior, reward. We see fruit, we eat it, if it tastes good we experience pleasure, and we create a memory to come back for more.
This reward-based learning system is useful when we’re recalling healthy behaviors, but when it comes to addiction to alcohol, drugs and cigarettes, these substances hijack our reward-based learning system. These substances affect the mesolimbic pathway in the brain, which acts primarily through the neurotransmitter dopamine. Each time we feel stressed or depressed and we use drugs, alcohol or cigarettes and experience the “reward” of a brief high or increased relaxation, we reinforce the habit loop in our brain.
Treatments such as Cognitive-Behavioral Therapy (CBT) act on the prefrontal cortex—the area of the brain involved in higher level or executive cognitive functions. When we are stressed, the more primitive regions of the brain are activated to focus on survival and dealing with perceived threats, and the prefrontal regions are deactivated. This makes us more susceptible to using substances when we are stressed. CBT therefore becomes an ineffective option when the individual is stressed, tired, hungry, angry, etc., as the prefrontal cortex, which CBT acts on, becomes inactivated.
Mindfulness training continues to emerge as a viable alternative for treatment of addictions. Mindfulness is awareness of the present moment without judgment. We experience the present moment through sensations, feelings, and thoughts. Mindfulness training can support individuals in paying attention to sensations, feelings, and thoughts that give rise to cravings an then help them learn to surf the urge of the craving, watching it rise, crest and then fall like a wave, instead of acting on the urges of an impulse. Individuals learn to se clearly what sensations, feelings or thoughts they are attempting to escape through numbing out their experiences with substances. And mindfulness training gives them the skillful means to cope effectively with sensations, feelings or thoughts that they perceive as difficult or intolerable.
When individuals begin to bring mindful awareness to their cravings and learn to ride the wave instead of acting on the impulse, they learn to consciously choose their actions. In addition, bringing mindful awareness to the aftereffects of using substances often results in disenchantment with the substance, which also supports recovery.
Recent research by Judson Brewer, MD, PhD, a researcher at Yale Therapeutic Neuroscience clinic, has found mindfulness training to be helpful for many addictions, including alcohol, cocaine and nicotine. One of Brewer’s randomized clinical trials found mindfulness training to be twice as effective as the American Lung Association’s Freedom from Smoking program in helping people to quit smoking and avoid future relapses.
Mindfulness works so well because it targets the addictive loop in the brain. When people ride out the wave of cravings instead of acting on the impulse to use, this separates the pairing of the link between the craving and using, which dismantles the addictive loop.
If you’re interested in quitting smoking, Dr. Brewer has created an app called Craving to Quit that delivers brief mindfulness training to smokers who are interested in learning mindfulness for smoking cessation.
If you’re interested in mindfulness training register for the Mindfulness Based Stress Reduction MBSR online course.
Jen Johnson is a mindfulness coach and therapist. She teaches meditation for healing, creativity, and resilience. Jen has been practicing mindfulness meditation since 1985.