A mindfulness-based, stress and coping model of craving in methamphetamine users

• Published in: PloS one 2021-05, Vol.16 (5), p.e0249489
• Main Authors: Mutumba, Massy, Moskowitz, Judith T, Neilands, Torsten B, Lee, Ji-Young, Dilworth, Samantha E, Carrico, Adam W
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Affect (Psychology); Aged; Amphetamine-Related Disorders - psychology; Amphetamine-Related Disorders - therapy; Appraisals; Biology and Life Sciences; Bisexuality; Care and treatment; Complications and side effects; Craving; Cross-Sectional Studies; Data collection; Drug abuse; Drug use; Emotions; HIV; HIV Infections - pathology; Human immunodeficiency virus; Humans; Intervention; Male; Medicine; Medicine and Health Sciences; Methamphetamine; Methamphetamine - administration & dosage; Methods; Middle Aged; Mindfulness; Patient outcomes; Research and Analysis Methods; Residential areas; Sampling methods; Self Efficacy; Sexual and Gender Minorities - psychology; Sexually transmitted diseases; Social Sciences; Social Support; STD; Stress; Stress management; Substance abuse; Substance abuse treatment; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0249489

There is increasing interest in the role of mindfulness and mindfulness-based interventions to optimize recovery from a substance use disorder (SUD). However, relatively little is known about the theory-based psychological and social pathways whereby mindfulness could have beneficial effects for managing a chronic, relapsing SUD. Informed by Revised Stress and Coping Theory, the present cross-sectional study examined affective, cognitive, and social pathways whereby mindfulness is associated with lower methamphetamine craving. A total of 161 HIV-positive, methamphetamine-using sexual minority men completed a screening visit for a randomized controlled trial. Using a hybrid structural equation model, we examined pathways whereby mindfulness is associated with lower methamphetamine craving. We found that greater mindfulness was directly associated with lower negative affect and higher positive affect as well as indirectly associated with less methamphetamine craving. Interestingly, the indirect association between mindfulness and methamphetamine craving appeared to be uniquely attributable to positive affect. Only positive affect was indirectly associated with lower methamphetamine craving via higher positive re-appraisal coping and greater self-efficacy for managing triggers for methamphetamine use. Methamphetamine craving was supported by moderate associations with greater substance use severity and more frequent methamphetamine use. These findings support the role of mindfulness in cultivating positive affect, which could be crucial to build the capacity of individuals to manage methamphetamine craving as a chronic stressor that threatens recovery from SUD.