Tag Archives: mindfulness

Mindfulness Meditation and Substance Use Disorders

BrainWave
A Systematic Review of Literature

(This systematic review of the literature was written in March 2014 by the Site Administrator in partial fulfillment of the Masters of Science in Social Work at the University of Louisville)

In 2010, between 153 million and 300 million people aged 15-64 worldwide used an illicit substance at least once in the previous year (UNODC, 2012).  According to the Substance Abuse and Mental Health Services Administration (2013), in America alone, an estimated 23.9 million persons age 12 and older are current illicit drug users.  Of these, an estimated 22.2 million persons aged 12 and older were classified with substance dependence or abuse in the past year (SAMHSA, 2013).  These numbers raise serious concerns because addiction has far reaching health and social consequences.  It is estimated that there were between 99,000 and 253,000 deaths globally in 2010 as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma (such as vehicle accidents) (UNODC, 2012).  Additionally, drug abuse leads to maladaptive behaviors that interfere with the individual’s ability to function normally in the family, at work, and in the community at a cost to the nation in excess of $600 billion annually (National Institute on Drug Abuse, 2012).  Given the prevalence of addiction in the population and the toll it takes on individuals and society, the development of effective treatment interventions is of utmost importance.

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Stepping Out of Automatic Pilot

airplane-taking-offI have come to view the years I spent in active addiction as my having been trapped in state of perpetual unconsciousness.  That is not to say there was no mental or emotional activity.  On the contrary, whether I was getting high or not, my mind raced incessantly and my emotions swung to extremes.  I say that I was unconscious because all of this mental and emotional activity occurred without much if any apparent effort on my part as if it all were happening automatically.  I have since learned that these reactive patterns were conditioned in me from a very young age and were likely reinforced by both genetic and other biological factors.  Initially, alcohol and drugs soothed the perpetual state of anxiety (or, dissatisfaction, discontent, dis-ease, or dukkha, if you will) which pervaded my existence.  However, these powerful chemicals ultimately turned on me as they acted upon vulnerable reward, memory, and motivation circuitry in my brain to ensure that I would fall into the vicious downward spiral of addiction.  Thus the trap of addiction is complex and composed of myriad personal and environmental risk factors which conspire to form the trance of automaticity.  And so, for me the process of recovery has essentially entailed an awakening to the causes and conditions of these automatic reactive patterns.  More importantly, it has also been about learning to step out of and interrupt these patterns through cultivation of mindfulness.

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The Buddhism and Addiction Series (Part III of III)

PART III:

Religious Dilemmas and Spiritual Solutions

Religion as a Barrier to Recovery

At first glance, it would seem that gay men with substance use disorder would be ideally matched to AA for post-treatment recovery maintenance or aftercare.  As previously noted, gay men are especially vulnerable to the development of a narcissistic personality structure.  The philosophy of the AA program is that addiction is essentially a “disorder of the self” characterized by narcissistic traits.  The AA program is unique in that it addresses both the underlying pathological personality structure, and the substance use disorder, by way of spiritual transformation.  However, when spirituality gives way to overt religiosity – as it often does in AA – the program becomes inaccessible and exclusive, and more foreboding than welcoming.

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Mindful Living: A Proposed Relapse Prevention Project

Substance abuse prevention is generally thought to involve primary and secondary prevention strategies which target populations that have either not yet engaged in use of alcohol and drugs (though they may be at risk to do so), or those who are in the very early stages of alcohol and drug use (Wilson & Kolander, 2011). Though efforts to prevent the onset of addiction are important, of equal concern is substance use relapse prevention wherein the stabilization brought about during treatment is preserved, and long-term abstinence is promoted.

Unfortunately, it appears that relapse prevention is often viewed as an afterthought of treatment wherein patients are discharged with little meaningful guidance nor provision of resources to aid them moving forward in recovery (McClellan, Lewis, O’Brien, & Kleber, 2000). As experts in the field continue to acknowledge that addiction is a chronic rather than acute condition, the provision of continuing care for those who have completed treatment must likewise adapt to meet this emerging awareness. To this end, the following substance use relapse prevention project, Mindful Living, is proposed.
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