Mindfulness-based Stress Reduction in Drug Rehab

Inpatient or residential drug rehab programs can be stressful for residents on several different levels. Residents may experience stress as symptom of withdrawal. Some treatment sessions will likely activate emotions and trigger stress. For many patients, pre-existing stress played a major role in the development of their addiction. An effective approach to stress management would be expected to help many patients in their addiction recovery and increase retention in residential treatment facilities.

Mindfulness-based stress reduction is a relatively new approach to stress management in the drug rehab environment. Marcus et. al. compared mindfulness-based stress reduction to treatment as usual for reducing stress and increasing retention in a residential facility for substance use disorders.

What is mindfulness-based stress reduction?

Developed by Jon Kabat-Zinn, PhD, at the University of Massachusetts Medical Center in the late 1970s, mindfulness-based stress reduction (MBSR) is an 8-week course that combines meditation and yoga to help individuals cope with stress and pain. MBSR teaches individuals to cultivate mindfulness, or moment-to-moment awareness. Previous studies have found that MBSR may increase self-esteem and decrease the use of pain medication. Other studies have shown that meditation can effectively lower stress as well as blood pressure.

The current study looked at whether MBSR offered any benefits over treatment as usual for stress reduction. Researchers followed 459 participants who met DSM-IV criteria for substance dependence. One group of participants received MBSR training while the other group received treatment as usual. An analysis of time to dropout did not show a significant difference between the two groups. However, level of participation in MBSR was associated with a decreased likelihood of dropout. Researchers also found that higher scores on the Symptoms of Stress Inventory (SOSI) at intake were associated with increased likelihood of dropout.

This study supports further research on incorporating MBSR into drug rehab and other addiction treatment programs. MBSR appears to be a promising method of managing stress and increasing retention.

By cultivating mindfulness and teaching individuals how to pay more attention to their thoughts, feelings, and behaviors, MBSR may help drug rehab patients to not only reduce stress but also identify risky behaviors and potential triggers for relapse. Mindfulness-based cognitive therapy (MBCT), for instance, teaches individuals who suffer from repeated bouts of depression how to recognize negative moods and thought patterns. MBCT allows individuals to become familiar with various thought patterns associated with their depressed moods and develop new ways of responding to those thought patterns (rather than mindlessly reacting to them).

The first step in resolving a problem is identifying it. For many substance abusers, there is little time between the impulse to act and the act itself. With the increased capacity for mindfulness the individual in addiction recovery can become aware of a craving or a rising stress well in advance of it becoming a “crisis.” Knowing that trouble is on the way can help individuals in recovery use other tools and techniques for preventing the crisis, or coping effectively with it.

Reference

Marcus MT, Schmitz J, Moeller G, Liehr P, Cron SG, Swank P, Bankston S, Carroll DD, Granmayeh LK. Mindfulness-based stress reduction in therapeutic community treatment: a stage 1 trial. American Journal of Drug and Alcohol Abuse. 2009; 103-108.