Academic journal article Iranian Journal of Public Health

Examine the Relationship between Mindfulness and Drug Craving in Addicts Undergoing Methadone Maintenance Treatment

Academic journal article Iranian Journal of Public Health

Examine the Relationship between Mindfulness and Drug Craving in Addicts Undergoing Methadone Maintenance Treatment

Article excerpt


The drug abuse is a chronic relapsing disorder that overshadowed individual's life and creates many problems for the family and the commu- nity. The emotional problems, mental problems and ways of dealing with stress were stated as reasons for drug use (1). The clinical findings suggest that due to the chronic and relapsing na- ture of the substance dependence, after the De- tox phase, a lot of people return to use the drug again (2). Fadaee (2007) states that in the best conditions and the best treatments, six months after leaving, 95% of the addicts return to the drug addiction cycle again, and the remaining 5% will return to the cycle during the next one or two years (3). Among the effective factors in the substance abuse, craving has a more important role in returning and maintaining the position of substance abuse and drug-dependence in main- taining the situation of drug abuse and drug - dependence. Craving is an uncontrollable desire for the drug, a desire that if not be fulfilled, then, it is followed by a frequency of the physical and psychological sufferings as weakness, anorexia, anxiety, insomnia, depression and aggression (The National Institute on Drug Abuse (NIDA), 1996, quoted by 4). After reaching the state of abstinence, a strong desire to re-experience the drug effects is seen. This feeling may be seen for a few hours after quitting drugs up to several months after the end of treatment. This phe- nomenon usually is reported very much in the early months of detoxification, then, its fre- quency and severity is reduced, although it rarely disappears (5).

Recent studies have emphasized the fact that the processes of attention and craving (temptation) occupy the same neural areas in the brain. For ex- ample, Dave (2002) found evidence that showed the substance or drug -related cues activate areas of the brain, which are related to the attention pro- cess. It seems that these distinct identified areas have a role in the attention performance and in the drug craving (6).

In this regard, Westbrook et al. (2011) showed that the brain areas involved in the phenomenon of craving, including the anterior cingulate cortex (ACC), have less activity when the attention to the images of smoking is associated with the presence of mind compared to the attention without the presence of mind to these images. In addition, during the attention along with the mindfulness, clearly a reduced functional link existed between the ACC and other areas involved in craving (7).

In the recent ten years, mindfulness has attracted a lot of attention in the scientific community, and it is defined as the moment to moment awareness of the experience gained and purposeful attention along with the acceptance without judgment of the existing experiences (8). The mindfulness causes the enhanced attention to the experience of the person. To create an attention along with the presence of the mind, or what Tiffany (1999) calls it as non- automated processing or needed to try, is different directly with allocation of attention without thinking or automated attention caused by the memory network of drug usage and auto- mated navigation (9). Compared with Tiffany's theory, attention or automated processing does not prevent behavioral maps for the drug use, but it observes the mental or emotional output of the memory network. Paying attention to these mental events without subjective judgment means a change in the viewing experience or a decentral- ized perspective. Changing the perspective of an actor or subject to a viewer can reduce the inher- ent urgency of desire, or excitement, and in this way, the mindfulness can reduce the mental pres- sure created by the recall actuator and decrease the risk of relapse (8). Due to the lack of studies in this field at home and abroad, the need for more studies in this area was felt by the researchers.

The purpose of this study was to determine the relationship between mindfulness and craving as a potential factor in relapse of addiction among the drug addicts undergoing the maintenance treat- ment of methadone. …

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