Mindfulness meditation has gradually been included into a variety of health care programs to address issues such as mental health problems, physical diseases and addictions. However, precisely how mindfulness works, for whom, and for how long are not exactly outlined. Recent studies have investigated the mechanisms of action of mindfulness-based interventions in the prevention of relapse for substance use disorders. Other line of research focused on the assessment of mechanisms of action (physiological, cognitive and psychological) to customize more effective treatments for addictions. The purpose of this review was to underline some of the most recent literature (mainly cross-sectional) on the effects of mindfulness-based interventions for different kinds of addictions, offering a reflection about some of the mechanisms and processes underlying such interventions. Even though some promising results, more researches are needed in order to entail large, longitudinal, well controlled studies that examine the intentions, psychological, behavioral, and physiological characteristics of addicts participating in mindfulness-based treatments, to define mechanisms of action and help further the capacity to design mindfulness interventions for most effective application.

Keywords: mindfulness, addictions, treatment

There is a growing interest of psychosocial research in mindfulness/meditation and its role in coping with day-to-day stressors,¹ as well as a treatment for patients with mental health issues.^2,3 This mini review shows some empirical and clinical evidence, arguing that there may be applications for mindfulness approaches in the treatment of addictions. Penberthy⁴ revised the mindfulness-based interventions for addictions, and focused on the mindfulness-based relapse prevention. The author argued that it seems to be an effective treatment for reducing substance use relapse.

The concept of mindfulness was originally inspired by old Buddhist meditation practices. Much of the recent interest in mindfulness and mindfulness-based treatments can be traced to Kabat-Zinn¹ mindfulness-based stress reduction program. Mindfulness techniques have been incorporated into several treatments associated with improved health outcomes.⁵ It has enticed various domains, such as basic emotion research, clinical science, and neurosciences⁶ with these proliferated findings, researchers have attempted to operationally define mindfulness, including two main components as follows: awareness and attitude.⁷ However, Cardaciotto et al.⁸ have conceptualized mindfulness as a general tendency towards greater awareness of one's experiences, bringing an attitude of acceptance and non-judgment to these experiences. In fact, an attitude of openness and non-judgment is perceived as a crucial mechanism of change in promoting the positive benefits associated with mindfulness.⁹ Although “mindful” individuals may experience negative thoughts, they appear to exhibit a greater ability to “let go” of these thoughts and focus their attention on healthier ways of relating to their experiences.^10,11 The cultivation of mindfulness can create a significant change in the way individuals approach their experiences, allowing the development of greater stability, meaning, flexibility, and less reactivity.⁹

Mindfulness-based interventions are commonly carried in an eight-week format, comprising the following:

1. Weekly sessions of around 120 minute’s duration.
2. A psycho-education constituent.
3. Guided exercises.
4. CD’s of guided meditations for daily practice.
5. Varying themes for discussion-based intervention with the program facilitator.

Examples of mindfulness-based interventions used in addictions include Mindfulness-Based Relapse Prevention,¹² Mindfulness-Based Stress Reduction,¹³ Meditation Awareness Training,¹⁴ Mindfulness-Based Cognitive Therapy,¹⁵ and Mindfulness-Enhanced Cognitive Behavior Therapy.¹⁶

Studies about the role of mindfulness in addictions have mainly focused on the treatment of pathological gambling. Researchers discovered a negative association between dispositional mindfulness and gambling severity in problem gamblers,¹⁷ thought suppression,¹⁸ and psychological distress.¹⁹ Several recent case studies have verified that mindfulness can lead to a clinically significant alteration in patients with gambling problems.^16,19–22 Beyond gambling addiction, a single case study conducted by Shonin et al.¹⁴ have investigated workaholism, treated with a mindfulness approach, in which a patient was successfully treated using Meditation Awareness Training.²³ Important improvements after the training were also observed for relevant variables such as: psychological distress, sleep quality, work activities during free time, hours of work, and job performance.

According to Shonin et al.,²⁴ empirical studies of the role of mindfulness in the treatment of addictions have exclusively focused on workaholism or gambling. Based on a review and assessment of the mechanisms underlying the enhancements enabled by the use of mindfulness in problem gamblers, the authors argued that mindfulness-based approaches are likely to have psychotherapeutic utility across a wider variety of addictions (e.g., sex, internet, video games, etc.). Main mindfulness-based treatment processes proposed for chemical addictions, include:

1. A perceptual change in the approach of relating to sensations, cognitions an emotion, apprehending cognitive processes as transitory events.
2. Use mindfulness to decrease relapse symptoms via relieving maladaptive coping related to addictive behaviors.
3. Shifting the focus on stress from external conditions to internal resources (metacognitive and attentional processes).
4. The change of negative mood states via the cultivation of self-compassion.
5. decreases of focus on reward.
6. Higher spiritual consciousness that encourages a re-evaluation of life primacies.
7. Focus on adopting an non-reactive attentional-set, non-judgmental and observatory mental processing (‘urge surfing’).
8. Reduced psycho physiological arousal through conscious induced breathing.
9. Enlarged capacity to accept gratitude and improve patience.
10. a higher competence on labeling and regulate mental ‘impulses’ and negative thinking patterns.²⁴

Recent findings in the treatment of addictions indicate that there might be important applications for mindfulness-based interventions in this field. However, further studies (with larger-sample controlled study designs) are undoubtedly needed, and should focus on addressing some of the questions that currently hamper the wide scale practice of mindfulness approaches in addiction treatments.²⁵ Moreover, it is still unclear what defines the mindfulness construct.^7,26,27 Finally, it is important to underline that there might be some risks, and adverse effects, of mindfulness-based interventions, that are aggravated due to a misunderstanding of what really constitutes an effective mindfulness training, routine, and teachings. Regardless of, recent empirical and clinical findings appear to assent that mindfulness meditation is a non-invasive, harmless and cost-effective approach for improving general psychological health, as well as for treating addictions.²⁸

None.

The author declares no conflict of interest.

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