Mindfulness-Oriented Recovery Enhancement Reduces Illicit Substance Craving Among People with Alcohol Use Disorder and Polysubstance Use.

Background

Polysubstance use is common in alcohol use disorder (AUD) and associated with poor treatment outcomes. Cannabis and cocaine often co-used with alcohol, have no approved medication treatments and respond poorly to common behavioral treatments. Thus, treatments that can reduce use of these substances alongside AUD are critically needed.

Objectives

We tested whether Mindfulness-Oriented Recovery Enhancement (MORE), an evidence-based group therapy approach combining mindfulness, cognitive-behavioral techniques, and savoring natural rewards could simultaneously reduce cravings for cannabis and/or cocaine. Given MORE's demonstrated efficacy for treating other addictive behaviors, we hypothesized it would reduce craving for cannabis and/or cocaine in people with AUD.

Methods

Participants (N = 50) were adults with AUD who also used cocaine and/or cannabis. Participants were randomly assigned to ten-sessions of either MORE or supportive group (SG) psychotherapy control condition, both targeting at AUD. Illicit substance craving was assessed before and after treatment during a cue reactivity protocol consisting of a resting baseline, 5-min stress imagery exposure, 5-min alcohol image exposure, and 5-min recovery period.

Results

Results revealed a significant Group-X Time interaction, F = 7.06, p=.008, indicating that patients randomized to MORE reported significantly greater reductions in illicit substance craving across the entire cue-reactivity protocol from pre- to post-treatment. However, the Group-X Time-X Condition interaction was nonsignificant (p=.61), indicating that the effect of MORE did not significantly vary by condition.

Conclusion

Results from this pilot study suggest that MORE may reduce illicit substance craving in patients with polysubstance use and AUD. MORE should be further evaluated in full-scale randomized clinical trials for cannabis and cocaine use disorder.