Mindfulness practice moderates the relationship between craving and substance use in a clinical sample
Abstract
Relapse following treatment for substance use disorders is highly prevalent, and craving has been shown to be a primary predictor of relapse. Mindfulness-Based Relapse Prevention (MBRP) is a psychosocial aftercare program integrating mindfulness and cognitive-behavioral approaches, aimed at reducing the risk and severity of relapse. Results from a recent randomized clinical trial demonstrate enhanced remission resilience for MBRP participants versus both cognitive-behavioral and treatment-as-usual controls. The current study investigated between-session formal and informal mindfulness practice, a hypothesized primary mechanism of action in this treatment, as an attenuating factor in the relationship between craving and substance use. Participants in this secondary analysis were 57 eligible adults who completed either inpatient treatment or intensive outpatient treatment for substance use disorders, were randomized in the parent study to receive MBRP, and completed relevant follow-up assessments. For formal mindfulness practice at post-intervention, both number of days per week and number of minutes per day significantly moderated the relationship between craving at post-intervention and number of substance use days at 6-month follow up. Informal practice did not significantly influence the craving-use relationship in this analysis. These results indicate that increasing formal mindfulness practice may reduce the link between craving and substance use for MBRP participants and enhance remission resiliency.
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Evidence indicates that mindfulness interventions work through reducing stress and craving and improving mindfulness and interoceptive awareness.
“Evidence indicates that mindfulness interventions work through reducing stress and craving and improving mindfulness and interoceptive awareness [15,19,20,28–32].”
From Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder (2025) · cites this paper as [30]
The findings are consistent with other studies that have demonstrated the positive impact of mindfulness interventions on stress and mindfulness constructs.
“Our findings are consistent with other studies that have demonstrated the positive impact of mindfulness interventions on stress and mindfulness constructs [12,15,16,19,20,25–27,30,32].”
From Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder (2025) · cites this paper as [30]
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- Authors
- Enkema, M. C., & Bowen, S.
- Affiliations
- University of Washington (US)
- Pacific University Oregon (US)
- Corresponding author
- Enkema, Matthew C.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2017-10
- Volume
- 179
- Pages
- 1-7
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2547541253
- Cited by
- 72
- References
- 69
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 14 · 2020: 7 · 2019: 9 · 2018: 9 · 2017: 1 · 2015: 1
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- ResearchWorks at the University of Washington (University of Washington) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R01DA025764)
- 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 practice, craving, substance use, relapse, mindfulness-based relapse prevention, substance use disorders, moderation
- MeSH terms
- Humans, Recurrence, Cognitive Behavioral Therapy, Substance-Related Disorders, Secondary Prevention, Mindfulness, Craving
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