Mindfulness-based interventions for addictive behaviors: implementation issues on the road ahead
Open accessAbstract
Over the past 35 years, mindfulness meditation practices have increasingly been integrated into Western medical settings. Research into the benefits of mindfulness-based interventions (MBIs) continues to expand, such that there are currently more than a dozen different protocolled MBIs for patients suffering from a variety of physical and psychological disorders. In the last decade, a number of MBIs specifically designed to treat addictive behaviors have been developed and tested. This review first provides a brief overview of the current state of the science with respect to the efficacy of MBIs for addictive behaviors, and some of the proposed mechanisms underlying the efficacy of MBIs. Second, the review highlights unresolved implementation issues and provides suggestions for how future research can address the implementation challenges to advance the delivery of MBIs. Specifically, this review focuses on the lack of clear empirical guidelines in the following areas: (a) effective training for MBI treatment providers; (b) adaptations of the traditional 2-hr closed-cohort group format; (c) delivery of MBIs in 1-on-1 treatment contexts; (d) delivery of MBIs at different points in the change process; (e) delivery of MBIs via technology-based platforms; and (f) facilitation of precision medicine in the delivery of MBIs. Specific research directions are suggested with an eye toward a meaningful increase in access to MBIs for front-line clinicians and clients. (PsycINFO Database Record
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There is a significant evidence gap in LMICs regarding the feasibility of implementing MBRP in more diverse or real-world treatment contexts.
“Therefore, there is a significant evidence gap in low-and middle-income countries (LMICs) regarding the feasibility of implementing MBRP in more diverse or “real-world” treatment contexts (16).”
From A mindfulness-based intervention for Substance Use Disorder in a Brazilian vulnerable population: a feasibility mixed method study (2024) · cites this paper as [16]
The Key Implementation Issues section identifies gaps in evaluating MBRP in flexible formats and says further research will inform whether rolling-admission MBRP is feasible in diverse real-world treatment settings. It does not identify LMICs as the setting for that evidence gap, so the geographic qualification is unsupported. (LLM, conf=0.88)
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“21 However, to date there is not enough evidence to guide the implementation of MBP in stepped care formats, rolling admissions or shorter sessions.”
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“Besides depression, mindfulness meditation can improve attention deficit hyperactivity disorder [23] and drug addiction [24] and can reduce impulsivity in middle-and high-school students [25].”
Spiritual and religious influences
Groves, P. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-816720-5.00008-6 · Cited by 4 · see citing works
Machado, M. P. A., Opaleye, E. S., Bedendo, A., Bowen, S., & Noto, A. R. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1381489 · Cited by 3 · see citing works
Moniz-Lewis, D. I. K., Votaw, V. R., & Witkiewitz, K. A. (2024) · Journal of Health Service Psychology · doi:10.1007/s42843-024-00100-8 · Cited by 3 · see citing works
“Although MBIs show promise for reducing substance use and supporting long-term recovery (Korecki et al., 2020; Li et al., 2017), aspects of these intervention formats (e.g., two-hour closed-cohort groups) might make them difficult to implement in real-world treatment settings (Wilson et al., 2017).”
Dey, M., Wenger, A., Baumgartner, C., Herrmann, U., Augsburger, M., Haug, S., Malischnig, D., & Schaub, M. P. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03802-9 · Cited by 3 · see citing works
“Other meta-analyses and systematic reviews have also yielded promising results concerning the effectiveness of MBI treating SUD [33, 40–44].”
BackgroundInfluentialCurrent treatments of alcohol use disorder
Dionisi, T., Sario, G. D., Mori, L. D., Spagnolo, G., Antonelli, M., Tarli, C., Sestito, L., Mancarella, F. A., Ferrarese, D., Mirijello, A., et al. (2024) · International review of neurobiology · doi:10.1016/bs.irn.2024.02.005 · Cited by 4 · see citing works
Managing Pain in Patients With Comorbid Alcohol Use Disorder and Chronic Pain
Maleki, N., Thompson, B., Janiuk, K., Dhingra, L. K., & Chen, L. L. (2024) · Current Addiction Reports · doi:10.1007/s40429-024-00563-1 · Cited by 3 · see citing works
“Acceptance-and mindfulness-based interventions aim to foster an attentive awareness of the present moment, as well as promoting a nonjudgmental mindset toward oneself, others, and current circumstances [71, 94].”
Contreras-Pérez, M. E., Alessi, S. M., Langwerden, R. J., Morris, S. L., & Wagner, E. F. (2023) · Addictive Behaviors · doi:10.1016/j.addbeh.2023.107759 · Cited by 2 · see citing works
Jm, B.-G. (2019) · Annals of Psychiatry and Treatment · doi:10.17352/apt.000010 · Cited by 1 · see citing works
“The “Mindfulness-Based Relapse Prevention” or MBRP program is specifi cally for patients with addictions, whether substance-related or not [50-52].”
BackgroundPélerin, J.-M., Gegout, T., Schwitzer, T., Schwan, R., Albuisson, É., Gedor, M., Laprévote, V., & Bourgognon, F. (2025) · L Encéphale · doi:10.1016/j.encep.2024.11.014 · Cited by 1 · see citing works
Saadati, M., Etemadi, Z., Hajiabadi, V. R., Sajadi, M., Sohrabnejad, S., & Afshar, S. E. (2025) · Journal of Archives in Military Medicine · doi:10.5812/jamm-165078 · Cited by 1 · see citing works
The Roles of Endogenous D2R Dopamine and μ-opioid Receptors of the Brain in Alcohol use Disorder
Khikhmetova, K., Semenova, Y. M., & Bjørklund, G. (2023) · Current Medicinal Chemistry · doi:10.2174/0109298673248999231013043249 · Cited by 1 · see citing works
Tobacco Economics, Banks, and Mindful Solutions for Long-Term Sustainability
Singha, R., & Singha, S. (2025) · Springer eBooks · doi:10.1007/978-981-96-1785-2_12 · Cited by 1 · see citing works
Recovery Habits: A Habit Perspective on Recovery from Substance Use Disorder
Arnaudova, I., Amaro, H. D. L. A., & Monterosso, J. R. (2018) · Springer eBooks · doi:10.1007/978-3-319-97529-0_17 · Cited by 1 · see citing works
Evidence-Based Behavioral Treatments
Hammarberg, A., & Ingesson, S. (2023) · Springer eBooks · doi:10.1007/978-3-031-32483-3_15
石, 威. (2024) · Advances in Psychology · doi:10.12677/ap.2024.143132
Yamada, S., Arimitsu, K., Buyo, M., Mukai, T., Noguchi, R., Akiko, M. I. S. U., Sonoki, T., & HAYASHI, M. (2025) · Japanese Journal of Complementary and Alternative Medicine · doi:10.1625/jcam.22.9
Harerimana, A., Pillay, J. D., & Mchunu, G. G. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100540
Calderone, A., Latella, D., Todaro, A., Luca, R. D., Militi, D., Fauci, E. L., Sergi, A., Quartarone, A., & Calabrò, R. S. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2025.2606861
“Contemporary mechanistic reviews argue that such decoupling of internal experiences from behavior constitutes a central pathway through which MBIs and ACT reduce addictive behavior (Demina et al., 2023; Garland & Howard, 2018; Wilson et al., 2017).”
Morris, B., & Harrison, B. (2026) · Mental Health and Social Inclusion · doi:10.1108/mhsi-12-2025-0322 · Cited by 1 · see citing works
Roos, C. R., Witkiewitz, K. A., Bowen, S. W., Kiluk, B. D., Bricker, J., Mun, C. J., Baillet, E., John, M., & Hedy Kober, A. (2026) · Mindfulness · doi:10.1007/s12671-026-02836-4
- Authors
- Wilson, A. D., Roos, C. R., Robinson, C. S., Stein, E. R., Manuel, J. A., Enkema, M. C., Bowen, S., & Witkiewitz, K.
- Affiliations
- University of New Mexico (US)
- Pacific University (IN)
- University of Washington (US)
- ORCID
- Venue
- Psychology of Addictive Behaviors
- Published
- 2017-12
- Volume
- 31
- Issue
- 8
- Pages
- 888-896
- ISSN
- 0893-164X (ISSN-L)
- 1939-1501
- PMC
- PMC5714676
- OpenAlex
- W2765487234
- Cited by
- 41
- References
- 79
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 4 · 2018: 3
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychology of Addictive Behaviors (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32 AA018108, R21 AA024926)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- mindfulness-based interventions, addictive behavior, addiction treatment, implementation barriers, individual psychotherapy, stages of change, precision medicine, access to treatment
- MeSH terms
- Humans, Behavior, Addictive, Practice Guidelines as Topic, Precision Medicine, Mindfulness
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