Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Systematic Review

• Main Authors: Grant, Sean, Hempel, Susanne, Colaiaco, Benjamin, Motala, Aneesa, Shanman, Roberta M, Booth, Marika, Dudley, Whitney, Sorbero, Melony E
• Format: Report
• Language: English
• Subjects: ADJUNCTIVE THERAPY; CLINICAL TRIALS; COMPARISON; DRUG ABUSE; LITERATURE SURVEYS; MBRP(MINDFULNESS-BASED RELAPSE PREVENTION); Medicine and Medical Research; MONOTHERAPY; Psychology; RCT(RANDOMIZED CONTROLLED TRIALS); SUD(SUBSTANCE USE DISORDERS)

This systematic review aims to synthesize evidence from trials of Mindfulness-Based Relapse Prevention (MBRP) to provide estimates of its efficacy and safety for substance use disorders (PROSPERO record CRD42015016380). In December 2014, we searched PubMed, PsycINFO, AMED, CINAHL, CENTRAL, Web of Science, and bibliographies of existing systematic reviews and included studies to identify English-language randomized controlled trials (RCTs) evaluating the efficacy and safety of MBRP used adjunctively or as monotherapy to treat substance use disorders in adults diagnosed with alcohol, opioid, stimulant, and/or cannabis use disorder. Two independent reviewers screened identified literature using predetermined eligibility criteria, abstracted prespecified study-level information and outcome data, and assessed the quality of included studies. Outcomes of interest included relapse, frequency and quantity of substance use, withdrawal/craving symptoms, treatment dropout, functional status, health-related quality of life, recovery outcomes, and adverse events. When possible, meta-analyses were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Strength of evidence was assessed using the GRADE approach. Six studies (reported in 20 publications) with 685 participants were included. Evidence was insufficient to determine whether MBRP effects differ by type of substance use targeted. There were no significant effects for MBRP as an adjunctive therapy or a standalone monotherapy for most outcomes; we did find some evidence in support of MBRP evaluated as an adjunctive therapy based on one RCT with regard to quality of life (SMD 0.65; CI 1.20 to 0.10; 1 RCT; very low quality evidence) and legal problems (SMD 1.20; CI 1.78 to 0.62; 1 RCT, very low quality evidence), yet these outcomes were not measured in any RCTs of MBRP as a monotherapy to serve as a comparison with effects for MBRP as an adjunctive therapy. Sponsored in part by the Office of the Secretary of Defense.