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Addictions and substance use disorders (SUD) are widespread and difficult to treat. Researchers are continually conducting new studies to evaluate the effectiveness of various treatments, focusing on what makes them effective.
This particular study looked at two different types of psychological support to see if they had different effects.[1] Here’s what you need to know.
Why is it so difficult to stop taking opioids?
Opioids are highly addictive, and opioid use disorder (OUD) is growing rapidly, especially in the US. The CDC estimates that at least 3.7% of American adults need treatment for OUD.[2]
Quitting opioids can be a difficult process. Opioids activate the reward circuitry in the brain more effectively than similar neurotransmitters (like dopamine and serotonin) that occur naturally. Because opioids create powerful cravings that are easily triggered, the brain quickly develops a tolerance for these drugs, meaning that increased doses are required for the same effects.[3]
Withdrawal effects from opioids are unpleasant and can be dangerous in some cases. People with SUD often use other medications to reduce withdrawal symptoms and manage cravings. It is hard to estimate how many people successfully quit opioids, especially given the high rates of relapse. One study found that 23% of incarcerated people with OUD were opioid-free after 33 years.[4]
Between 40-70% of people with any form of SUD drop out of treatment.[5] Risk factors for dropping out of treatment include polysubstance use, high levels of anxiety, or continuing to experience cravings despite medication.[1]
Understanding the study
This study looked at factors that might increase the success rate of people already being treated for OUD. Patients who were currently receiving buprenorphine for OUD were recruited online from 16 states. [1] The buprenorphine was used to support chemical withdrawal and reduce cravings.[6] For this study, participants were also given one of two types of online group support.
The first group, known as the recovery support group, received treatment based on current best practices. This involved eight weeks of building trust within the group, followed by 16 weeks of a combination of cognitive-behavioral therapy (CBT), motivational interviewing, and peer support modeled on the 12-step programs.[7]
The mindfulness group had the same number of sessions, but these were focused on mindfulness skills, such as breathing techniques, self-compassion, and emotional regulation. They also learned OUD-specific mindfulness tools, such as urge surfing.
There were no significant differences between the two groups in opioid use or levels of anxiety. Cravings for opioids decreased in both groups throughout the study, but the reduction in cravings was greater in the mindfulness group. The recovery support group had a 44% reduction in cravings, as compared to 67% in the mindfulness group.
What does this mean for someone trying to quit opioids?
Previous studies have already shown that medication alone doesn’t address all aspects of OUD. Importantly, they appear to have a strong effect on the likelihood of someone continuing with treatment.[8] This study demonstrates that mindfulness can be as effective as other forms of psychological or behavioral support.
One of the challenges of treating complex disorders, such as OUD, is trying to find the best treatment for each individual. This study suggests that mindfulness might be the first choice of support for people who continue to experience cravings while taking medication such as buprenorphine.
Another challenge associated with treating OUD is the high cost of many interventions, especially residential care. The interventions used here were online group sessions, which are significantly more cost-effective than some other options. While this study didn’t evaluate any of the more expensive interventions, it did demonstrate that low-cost techniques can have a positive impact on outcomes for people with OUD.
