Mindfulness-Based Relapse Prevention for substance craving
Open accessAbstract
Craving, defined as the subjective experience of an urge or desire to use substances, has been identified in clinical, laboratory, and preclinical studies as a significant predictor of substance use, substance use disorder, and relapse following treatment for a substance use disorder. Various models of craving have been proposed from biological, cognitive, and/or affective perspectives, and, collectively, these models of craving have informed the research and treatment of addictive behaviors. In this article we discuss craving from a mindfulness perspective, and specifically how mindfulness-based relapse prevention (MBRP) may be effective in reducing substance craving. We present secondary analyses of data from a randomized controlled trial that examined MBRP as an aftercare treatment for substance use disorders. In the primary analyses of the data from this trial, Bowen and colleagues (2009) found that individuals who received MBRP reported significantly lower levels of craving following treatment, in comparison to a treatment-as-usual control group, which mediated subsequent substance use outcomes. In the current study, we extend these findings to examine potential mechanisms by which MBRP might be associated with lower levels of craving. Results indicated that a latent factor representing scores on measures of acceptance, awareness, and nonjudgment significantly mediated the relation between receiving MBRP and self-reported levels of craving immediately following treatment. The mediation findings are consistent with the goals of MBRP and highlight the importance of interventions that increase acceptance and awareness, and help clients foster a nonjudgmental attitude toward their experience. Attending to these processes may target both the experience of and response to craving.
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Individuals who received MBRP and showed lower distress tolerance reported greater reductions in alcohol and other drug use frequency over time and craving scores compared to TAU, although the changes were not maintained at the 4-month follow-up.
“With regard to MBRP versus TAU, individuals who received MBRP and showed lower distress tolerance reported greater reductions in alcohol and other drugs use frequency over time (61) and craving scores (53, 69), although the changes were not maintained at the 4-month follow-up (61).”
From Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review (2018) · cites this paper as [69]
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Experimental — accuracy not yet measuredIn a RCT of MBRP among a heterogenous sample of individuals with various substance use disorders, increases in dispositional mindfulness facets like acceptance, awareness, and nonjudgment significantly mediated the effect of MBRP on decreasing craving following treatment.
“In a RCT of MBRP among a heterogenous sample of individuals with various substance use disorders, increases in dispositional mindfulness facets like acceptance, awareness, and nonjudgment significantly mediated the effect of MBRP on decreasing craving following treatment [39].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [39]
One of the strongest candidates to emerge as a predictor of relapse in substance use disorders is craving.
“Much research has focused on identifying predictors of relapse in substance use disorders, and one of the strongest candidates to emerge from these studies is craving (86).”
From Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice (2019) · cites this paper as [86]
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“, 2016), reducing substance cravings (Witkiewitz et al., 2013), and enhancing overall quality of life (Chiesa et al.”
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“Mindfulness components are hypothesized to increase acknowledgment, awareness, and tolerance of strong emotions (Bowen et al., 2009; Bowen et al., 2014; Brown et al., 2007; Witkiewitz et al., 2013).”
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- Authors
- Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. H.
- Affiliations
- Washington State University Vancouver (US)
- University of Washington (US)
- Corresponding author
- Witkiewitz, Katie
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 38
- Issue
- 2
- Pages
- 1563-1571
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC3408809
- OpenAlex
- W1981403100
- Cited by
- 337
- References
- 80
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 25 · 2023: 24 · 2022: 21 · 2021: 36 · 2020: 19 · 2019: 30 · 2018: 34 · 2017: 29 · 2016: 20 · 2015: 26 · 2014: 29 · 2013: 11 · 2012: 2
- FWCI
- 16.22
- Type
- journal article
- Language
- en
- Update notices
- erratum (2018-07-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Development Administration (R21-DA019562)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- mindfulness-based relapse prevention, drug craving, substance use disorders, acceptance, awareness, non-judgment, mediation, relapse prevention
- MeSH terms
- Adult, Attention, Awareness, Female, Humans, Male, Time Factors, Models, Statistical, Behavior, Addictive, Outcome Assessment, Health Care, Meditation, Substance-Related Disorders, Secondary Prevention, Self Report
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