New Study Investigates Mindfulness Meditation for Alcohol Relapse Prevention

Department of Family Medicine (DFM) Assistant Professor Aleksandra Zgierska, MD, PhD, is leading a groundbreaking study to determine whether mindfulness meditation can help recovering alcoholics stay sober.

Why Mindfulness Meditation?

Mindfulness meditation is a centuries-old technique that encourages non-judgmental attentiveness to and awareness of the current state of one's body and mind. With regular practice, it may enhance one's ability to make conscious behavioral choices.

Mindfulness meditation-based therapy has been found to be a safe and effective way to treat anxiety, depression, stress, and chronic pain, as well as many other medical and mental health conditions.

Early research and anecdotal evidence suggest it may also be valuable for people struggling with alcohol dependence and other types of substance abuse.

In 2008, Dr. Zgierska published the results of a pilot study that showed mindfulness meditation was a promising adjunct therapy for alcohol relapse, with results similar to those of conventional therapies.

The current study expands on that pilot, and is one of just a few rigorous studies on the connection between meditation and addiction.

"People have been using mindfulness meditation techniques for thousands of years, including for addiction," said Dr. Zgierska. "It's just new to research."

And even though mindfulness meditation is still outside mainstream medicine, anecdotal accounts of its effectiveness have led more and more addiction counselors to implement it into their clinical practices. "The research is actually lagging behind the practice," she said.

Study Design

The current study is the first randomized controlled trial evaluating the effectiveness of mindfulness meditation as a therapy for alcohol dependence.

Dr. Zgierska's team began enrolling the first set of participants in February 2010. They recruited alcohol-dependent adults from three Madison outpatient treatment centers: UW Health's Gateway Recovery, Meriter's NewStart, and Tellurian UCAN.

Each participant will be randomly assigned to a control or an experimental group. Participants in both groups will receive standard-of-care therapy, which includes motivational enhancement, relapse prevention, and 12-step strategies, through the treatment center.

Participants in the experimental group will also receive an additional intervention called Mindfulness Based Relapse Prevention, originally developed by Dr. Alan Marlatt at the University of Washington, Seattle, which consists of:

• an introductory informational meeting;
• 16 hours of intensive, in-person mindfulness meditation training (8 group sessions lasting 2 hours each);
• 30 minutes of at-home practice 6 days per week; and
• a set of meditation CDs to guide at-home practice.

The research team will gather data on each participant at the beginning of the study, after 8 weeks, and after 26 weeks. Data includes:

• Self-reported alcohol use, drinking-related harms, mental health problems, and satisfaction with and adherence to the therapy;
• data for cost-effectiveness analysis; and
• stress hormone (cytokine) and liver enzyme levels, as determined by blood tests.

The team will evaluate 112 total participants—56 in the control group, 56 in the experimental group—over the course of the trial.

The study is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). It is part of the National Institutes of Health (NIH) Career Development Award that Dr. Zgierska received in 2009 (read related article).

Potential Impact on Lives and Society

Dr. Zgierska believes that a key benefit of mindfulness meditation is its potential to improve a person's overall psychological well-being.

And that may help reduce one of the most common and challenging problems of alcohol dependence treatment: the likelihood of relapse.

Studies have shown that even after the best standard-of-care treatment, over half of alcohol-dependent patients relapse within a year.

Furthermore, approximately one-third of alcoholics also struggle with anxiety, depression, and stress—all of which are known risk factors for relapse.

"This therapy doesn't just focus on the pathway of addiction," Dr. Zgierska explained. "It can be extrapolated to other areas in a person's life that may be problematic."

Dr. Zgierska stresses, however, that her goal—at this point—is not to replace standard-of-care therapy, but provide an effective adjunct to it.

"If we can broaden the repertoire of treatment choices for patients, they are more likely to find something that they resonate with," she explained. "That may help improve treatment retention, and eventually outcomes."