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Mindfulness-based treatments for co-occurring depression and substance use disorders: what can we learn from the brain?
Open accessAbstract
Both depression and substance use disorders represent major global public health concerns and are often co-occurring. Although there are ongoing discoveries regarding the pathophysiology and treatment of each condition, common mechanisms and effective treatments for co-occurring depression and substance abuse remain elusive. Mindfulness training has been shown recently to benefit both depression and substance use disorders, suggesting that this approach may target common behavioral and neurobiological processes. However, it remains unclear whether these pathways constitute specific shared neurobiological mechanisms or more extensive components universal to the broader human experience of psychological distress or suffering.We offer a theoretical, clinical and neurobiological perspective of the overlaps between these disorders, highlight common neural pathways that play a role in depression and substance use disorders and discuss how these commonalities may frame our conceptualization and treatment of co-occurring disorders. Finally, we discuss how advances in our understanding of potential mechanisms of mindfulness training may offer not only unique effects on depression and substance use, but also offer promise for treatment of co-occurring disorders.
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“Further, by teaching smokers to focus their attention on what is happening in the moment, mindfulness‐based interventions bring habitual behaviours into consciousness.”
From Mindfulness for smoking cessation (2022) · cites this paper as Brewer 2010
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“This enables people to understand the associative learning process, and focus on affect and craving as central components of positive and negative reinforcement loops (Brewer 2010).”
From Mindfulness for smoking cessation (2022) · cites this paper as Brewer 2010
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“Moreover, ME may contribute to improve problematic smartphone users ' ability to tolerate discomfort associated with craving [14,46].”
From Comparative effectiveness of mind-body exercise versus cognitive behavioral therapy for college students with problematic smartphone use: A randomized controlled trial (2020) · cites this paper as [46]
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“As the positive association between problematic use level and mental health (i.e., loneliness, anxiety and stress) has been established [46,47].”
From Comparative effectiveness of mind-body exercise versus cognitive behavioral therapy for college students with problematic smartphone use: A randomized controlled trial (2020) · cites this paper as [46]
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“However, recent pilot studies have shown that mindfulness may be safe. In this population, it is recommended that practices are shorter, guidance is more frequent, and explicit reference is made to psychotic phenomena.23”
From Mindfulness in psychiatry - Where are we now? (2016) · cites this paper as [23]
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“Mindfulness exercises commonly focus on specific meditation exercises (e.g., mindful breathing, mindfulness of daily experiences such as washing dishes, mindful eating), with the intention of bringing an individual’s attention to one focal point again and again (Brewer et al., 2010).”
BackgroundInfluentialMitigating Gambling-Related Harms in Children and Young People: A Scoping Review of Interventions
Davis, C., Davidson, K., Arden-Close, E. J., Bolat, E., & Panourgia, C. (2025) · Journal of Gambling Studies · doi:10.1007/s10899-025-10387-x · Cited by 14
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“A number of authors have suggested that MBCT may be useful for depression with substance misuse (Brewer et al, 2010 ; Kay-Lambkin et al, 2007 ).”
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Mindfulness and the Addictive Process: Psychological Models and Neurobiological Mechanisms
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“In addiction settings, mindfulness training was linked to decreased substance use, craving, and drug abuse relapse rates by fostering greater interoceptive awareness and impulse control (Brewer et al., 2010).”
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“…for reducing stress (Kabat-Zinn & Hanh, 1990), treating pain-related disorders (Astin, Shapiro, Eisenberg, & Forys, 2003), decreasing depression (Brewer, Bowen, Smith, Marlatt, & Potenza, 2010), and promoting abstinence or other positive outcomes in addictions (Hendershot, Witkiewitz, George, &…”
BackgroundStrategies for Reducing Antipsychotic Polypharmacy
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“While mindfulness training has been studied in substance abuse and severe mental illness individually, no research has directly evaluated the efficacy of this intervention for people with cooccurring disorders (Brewer et al., 2010).”
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“Mindfulness meditation (MM) has been proposed to concurrently target co-occurring depression and addictive disorders (27) and thus has been incorporated into clinical interventions (28).”
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“The risk for alcohol relapse is increased among individuals with depression, a common comorbid mental health disorder among individuals in substance use treatment (Bradizza, Stasiewicz, and Paas 2006; Brewer et al. 2010).”
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“Consistent with the results of other studies[32,33] based on theoretical foundations, it seems adolescents with high levels of mindfulness would be better able to recognize disturbing experiences and with lower likelihood being engaged in substance abuse behaviors as a way to deal with such experiences.[34,35]”
Metadata
- Authors
- Brewer, J. A., Bowen, S., Smith, J. T., Marlatt, G. A., & Potenza, M. N.
- Affiliations
- Yale University (US)
- University of Washington (US)
- Corresponding author
- Brewer, Judson A.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2010-09-15
- Volume
- 105
- Issue
- 10
- Pages
- 1698-1706
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC2905496
- OpenAlex
- W2167010758
- Cited by
- 141
- References
- 177
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 11 · 2019: 8 · 2018: 12 · 2017: 8 · 2016: 9 · 2015: 11 · 2014: 15 · 2013: 14 · 2012: 10
- FWCI
- 13.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32 AA 07455-24, RL1AA017539, T32AA007455)
- National Institute of Mental Health (T32MH019961, R25MH071584)
- National Institute on Drug Abuse (K24DA017899, P50DA009241, K12 DA00167, R01DA020908, P50-DA-0-9241, K12DA000167, T32DA007238)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mindfulness-based interventions, dual diagnosis, neurobiological mechanisms, psychological distress, substance use disorders, depression
- MeSH terms
- Affect, Attention, Brain, Major Depressive Disorder, Humans, Neural Pathways, Stress, Psychological, Thinking, Cognitive Behavioral Therapy, Diagnosis, Dual (Psychiatry), Meditation, Mind-Body Relations, Metaphysical, Substance-Related Disorders, Secondary Prevention
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