Home > Mindfulness‐based interventions for substance use disorders.

Goldberg, Simon B and Pace, Brian and Griskaitis, Matis and Willutzki, Reinhard and Skoetz, Nicole and Thoenes, Sven and Zgierska, Aleksandra E and Rosner, Susanne (2021) Mindfulness‐based interventions for substance use disorders. Cochrane Database of Systematic Reviews, (10), Art. No.: CD011723. DOI: 10.1002/14651858.CD011723.pub2.

External website: https://www.cochranelibrary.com/cdsr/doi/10.1002/1...

Implications for practice
Results of this review provide low‐certainty evidence that mindfulness‐based interventions (MBIs) reduce percentage of days with substance use slightly relative to other treatments and high‐certainty evidence that MBIs result in little to no increase in attrition relative to no treatment or other treatments. The evidence for all other outcomes is very uncertain. Data on harm were minimal, although the available data showed no evidence of adverse effects. Indication of slight superiority to other treatments on one substance use outcome (percentage of days with substance use) may support inclusion of MBIs within the available treatment options for substance use disorders SUDs.

Implications for research
With the exception of estimates related to treatment acceptability (i.e. differential attrition), evidence related to substance use outcomes were of low or very low certainty due to imprecision and inconsistency. It is possible that an updated review with additional studies could result in more reliable estimates of treatment effects.

One of the most notable limitations of the current review is that few studies provided data necessary for estimating substance use outcomes. While it is certainly worthwhile to examine other outcomes within this population (e.g. depression, quality of life), assessing and reporting substance use (e.g. continuous abstinence, percentage of days used, consumed amount) will allow more rigorous evaluation of the effects of MBIs on these key dimensions. It would also be worth examining effects on other dimensions of substance use (e.g. negative effects of substance use). Future studies could more consistently report study design features (e.g. randomization and allocation procedure) and employ procedures to minimize risk of bias (e.g. blind outcome assessment, preregistration). It could be useful in a future and more highly‐powered review to examine moderators such as MBI type (e.g. mindfulness‐based relapse prevention (MBRP), mindfulness‐oriented recovery enhancement (MORE)), substance (e.g. various SUDs, alcohol), and country (e.g. USA, Iran) as well as patient‐level demographic characteristics (e.g. gender, race/ethnicity). Such analyses could determine whether effects vary along these dimensions and could guide decisions regarding when MBIs may or may not be indicated. Efforts to understand the efficacy of MBIs specifically in vulnerable populations (e.g. racial/ethnic minorities) is warranted. Larger RCTs and consistent reporting of adverse effects will also strengthen the certainty of evidence related to the use of MBIs for SUDs.

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