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Mind-body medicine in addiction recovery

Peter Grinspoon, M.D., Harvard Health Blog on

Published in Health & Fitness

As someone who struggled with a miserable opiate addiction for 10 years, and who has treated hundreds of people for various addictions, I am increasingly impressed with the ways in which mind-body medicine can be a critical component of recovery from addiction.

Mind-body medicine is the use of behavioral and lifestyle interventions, such as meditation, relaxation, yoga, acupuncture, and mindfulness, to holistically address medical problems. Mind-body treatments can be integrated with traditional medical treatments, or used as standalone treatments for certain conditions. Mind-body medicine is now being studied by the National Institutes of Health and effectively used in the treatment of addiction, and it will likely play a role in addiction recovery programs in the future.

Mind-body principles are not new to the recovery movement

Mind-body principles have been around since the start of the recovery movement in 1937, and they are a big part of Alcoholics Anonymous. The 12 Steps of AA feature concepts such as surrender, meditation, gratitude, and letting go — all critical components of mind-body medicine. Most 12-step meetings end with the Serenity Prayer: “God, grand me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Mutual help groups play a role in recovery for many people, and the principles of mindfulness that are part of these programs — in addition to the social support — shouldn’t be overlooked.

My experience with mind-body therapies for addiction

When I was sent to rehab for 90 days by the medical board due to my addiction, we participated in a lot of activities that seemed to be meant to approximate mind-body medicine, but they were haphazard and not particularly scientific, and I don’t believe they had the intended effect or were at all therapeutic. For example, we did shrubbery mazes (I’d get lost); we sat meditatively in silence (everyone around me chain-smoked, triggering my asthma); we had repeated lectures about “letting go and letting God” (I still have no idea what this means); we’d spend 30 minutes staring at a red square projected onto a screen (this gave me a migraine); and we went to a local acupuncture place where they hooked up extra electric current to the needles to give us extra “chi” (I felt like I was being cooked for dinner). Given that rehab is a $50 billion industry, I felt this was a lost opportunity to utilize mind-body medicine in a way that wasn’t superficial or trivial.

 

Formal mind-body therapies for addiction are being rigorously studied

Fortunately, there are now several scientifically based mind-body medicine options for people in recovery. Mindfulness-Based Relapse Prevention (MBRP) is a technique that uses meditation as well as cognitive approaches to prevent relapse. It aims to cultivate awareness of cues and triggers so that one doesn’t instinctively turn to using drugs. It also helps people get comfortable sitting with unpleasant emotions and thoughts —their distress tolerance, a person’s ability to tolerate emotional discomfort — without automatically escaping by taking a drug. Improving distress tolerance is a common theme to many, if not all, approaches to addiction recovery, as a large part of the appeal of drug use is replacing a bad emotion with a good emotion — for example, by using a drug.

Mindfulness-Oriented Recovery Enhancement (MORE) is another technique to address addiction in recovery. MORE attempts to use both mindfulness and positive psychology to address the underlying distress that caused the addiction in the first place. There are three main pillars of MORE: it has been proven to help with distress tolerance; cue reactivity (the way people with addiction respond to cues, such as seeing a bottle of prescription drugs, which often trigger cravings); and attentional bias (the way an addicted brain will pay extra, selective attention to certain things, such as a pack of cigarettes when one is quitting smoking).

Mindfulness-Based Addiction Therapy (MBAT) is a technique that uses mindfulness to teach clients how to notice current emotions and sensations, and how to detach themselves from the urge to use drugs. This is called “urge surfing,” and we practiced it extensively in rehab. The aim is to break the automatic link between feeling uncomfortable, craving drugs, and, without thought or reflection, taking a drug to alleviate that discomfort.

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