Academic journal article Iranian Journal of Psychiatry

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

Academic journal article Iranian Journal of Psychiatry

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

Article excerpt

According to a national epidemiologic study conducted by Ministry of Health (33), there are more than 1.2 million opioid dependents living across the country who use drugs usually smuggled into the country from Afghanistan. Currently, opioid maintenance treatment programs and short-term medically assisted withdrawal are delivered through a network of more than 2500 certified addiction treatment professionals at the national level. Although delivering psychosocial services in combination with medical management was emphasized in national methadone protocol (26), there is a scarcity of evidence in evidence-based psychosocial intervention for improving medical treatment outcomes .

Mindfulness is a technique comprised of meditation and a specific mental tendency toward experience that encourages an awareness of the present-moment experience. This awareness is non-evaluative and minimizes over-involvement with thoughts and emotions (28). In contrast to opioid maintenance treatment which has proved less effective in reducing the stress-induced craving (21), new approaches of psychotherapy that focus on mindfulness and acceptance might hypothetically enhance anti-craving properties of opioid maintenance treatment through reduction of stress-induced craving. Although the content of cognitive distortions constitute the main focus of cognitive behavioral therapies, mindfulness focuses primarily on assisting clients in examining their relationship with their thoughts. Mindfulness encourages patients to learn to monitor their own mental processes free of judgment and without being engaged in the actual content of their thoughts. The capability to respond to aversive cognitions, sensations, and emotions with an attitude of nonjudgmental, acceptance, and present-moment awareness forms the primary skill in mindfulness (29). Through mindfulness practices, the content of the thought becomes less important than the extent to which the individual is aware of it and how they react to the occurrence of the thought (29).

Mindfulness-based relapse prevention (MBRP) (5) is a program integrating mindfulness meditation practices with traditional relapse prevention (RP) whose effectiveness has been confirmed in different populations of drug users (4). Similar mindfulness-based programs for substance abuse have proved to increase compliance, cognitive control, and emotion regulation and reduce stress among alcohol dependents (12, 14, 17) and also affect various other related factors (8). The effectiveness of mindfulness in different populations of drug users suggests that more trials, in which the type of Mindfulness Based Group Therapy is clearly defined and described, are required to determine the efficacy of Mindfulness-Based Group Therapy for opioid dependence treatment .

The present study aimed to assess the effectiveness of Mindfulness-Based Group Therapy compared to the usual treatment for opioid dependence among different populations of opioid users.

Material and Methods

Participants

The opioid dependent clients who were receiving usual treatment in Iranian National Center for Addiction Studies (INCAS) were randomly assigned into intervention and control groups. INCAS Clinic, located in the southwest of Tehran, the capital of Iran, provides assisted withdrawal and maintenance treatment with opioid agonist medications including methadone and buprenorphine to its opioid dependent clients (96.6% male.

Eligibility criteria were as follows: a) diagnosis of opioid dependence according to DSM-IV-TR criteria, b) 18 to 40 years of age, c) at least 8 years of completed education, d) completion of two weeks of medical treatment with opioid agonist medication and e) informed written consent for participation in the study. The exclusion criteria were psychosis, dementia, imminent suicide risk, organic brain disorders, or diagnosis of other drug dependence (except nicotine).

Interventions

Intervention was a combination of eight sessions of mindfulness-based group therapy developed by Bowen et al. …

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