Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis

Sean Grant, Benjamin Colaiaco, Aneesa Motala, Roberta Shanman, Marika Booth, Melony Sorbero, Susanne Hempel

Research output: Contribution to journalReview article

Abstract

Objectives: Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs. Methods: We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46-1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI-0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD-0.09, 95% CI-0.39 to 0.21, low QoE), anxiety symptoms (SMD-0.32, 95% CI-1.16 to 0.52, very low QoE), and mindfulness (SMD-0.28, 95% CI-0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD-0.13, 95% CI-0.19 to-0.08, I 2 = 0%, low QoE) and negative consequences of substance use (SMD-0.23, 95% CI-0.39 to-0.07, I 2 = 0%, low QoE). We found negligible evidence of adverse events. Conclusions: We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

Original languageEnglish (US)
Pages (from-to)386-396
Number of pages11
JournalJournal of Addiction Medicine
Volume11
Issue number5
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Mindfulness
Secondary Prevention
Substance-Related Disorders
Meta-Analysis
Confidence Intervals
Randomized Controlled Trials
Odds Ratio
Substance Withdrawal Syndrome
Anxiety
Databases
Depression
Safety
Recurrence
Health

Keywords

  • meta-analysis
  • mindfulness
  • substance use disorder
  • systematic review

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Mindfulness-based Relapse Prevention for Substance Use Disorders : A Systematic Review and Meta-analysis. / Grant, Sean; Colaiaco, Benjamin; Motala, Aneesa; Shanman, Roberta; Booth, Marika; Sorbero, Melony; Hempel, Susanne.

In: Journal of Addiction Medicine, Vol. 11, No. 5, 01.01.2017, p. 386-396.

Research output: Contribution to journalReview article

Grant, Sean ; Colaiaco, Benjamin ; Motala, Aneesa ; Shanman, Roberta ; Booth, Marika ; Sorbero, Melony ; Hempel, Susanne. / Mindfulness-based Relapse Prevention for Substance Use Disorders : A Systematic Review and Meta-analysis. In: Journal of Addiction Medicine. 2017 ; Vol. 11, No. 5. pp. 386-396.
@article{152240856dd54ed78cc8aa7028bad748,
title = "Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis",
abstract = "Objectives: Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs. Methods: We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95{\%} confidence interval [CI] 0.46-1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95{\%} CI-0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95{\%} CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD-0.09, 95{\%} CI-0.39 to 0.21, low QoE), anxiety symptoms (SMD-0.32, 95{\%} CI-1.16 to 0.52, very low QoE), and mindfulness (SMD-0.28, 95{\%} CI-0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD-0.13, 95{\%} CI-0.19 to-0.08, I 2 = 0{\%}, low QoE) and negative consequences of substance use (SMD-0.23, 95{\%} CI-0.39 to-0.07, I 2 = 0{\%}, low QoE). We found negligible evidence of adverse events. Conclusions: We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.",
keywords = "meta-analysis, mindfulness, substance use disorder, systematic review",
author = "Sean Grant and Benjamin Colaiaco and Aneesa Motala and Roberta Shanman and Marika Booth and Melony Sorbero and Susanne Hempel",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/ADM.0000000000000338",
language = "English (US)",
volume = "11",
pages = "386--396",
journal = "Journal of Addiction Medicine",
issn = "1932-0620",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Mindfulness-based Relapse Prevention for Substance Use Disorders

T2 - A Systematic Review and Meta-analysis

AU - Grant, Sean

AU - Colaiaco, Benjamin

AU - Motala, Aneesa

AU - Shanman, Roberta

AU - Booth, Marika

AU - Sorbero, Melony

AU - Hempel, Susanne

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs. Methods: We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46-1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI-0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD-0.09, 95% CI-0.39 to 0.21, low QoE), anxiety symptoms (SMD-0.32, 95% CI-1.16 to 0.52, very low QoE), and mindfulness (SMD-0.28, 95% CI-0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD-0.13, 95% CI-0.19 to-0.08, I 2 = 0%, low QoE) and negative consequences of substance use (SMD-0.23, 95% CI-0.39 to-0.07, I 2 = 0%, low QoE). We found negligible evidence of adverse events. Conclusions: We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

AB - Objectives: Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs. Methods: We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46-1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI-0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD-0.09, 95% CI-0.39 to 0.21, low QoE), anxiety symptoms (SMD-0.32, 95% CI-1.16 to 0.52, very low QoE), and mindfulness (SMD-0.28, 95% CI-0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD-0.13, 95% CI-0.19 to-0.08, I 2 = 0%, low QoE) and negative consequences of substance use (SMD-0.23, 95% CI-0.39 to-0.07, I 2 = 0%, low QoE). We found negligible evidence of adverse events. Conclusions: We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

KW - meta-analysis

KW - mindfulness

KW - substance use disorder

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85029747288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029747288&partnerID=8YFLogxK

U2 - 10.1097/ADM.0000000000000338

DO - 10.1097/ADM.0000000000000338

M3 - Review article

C2 - 28727663

AN - SCOPUS:85029747288

VL - 11

SP - 386

EP - 396

JO - Journal of Addiction Medicine

JF - Journal of Addiction Medicine

SN - 1932-0620

IS - 5

ER -