Key DFM Personnel

Aleksandra Zgierska, MD, PhD - Principal Investigator
Michael Fleming, MD, MPH
Christopher Coe, PhD Department of Psychology
David Rabago, MD
Benjamin Craig, PhD
Megan Zuelsdorff, BS - Study Coordinator

Collaborating Institutions

NewStart Alcohol and Drug Treatment Program Madison, WI
University of Wisconsin Gateway Recovery Madison, WI
Tellurian UCAN Inc. Madison, WI

Funding

American Academy of Family Physicians, Wisconsin Academy of Family Physicians
Department of Family Medicine, University of Wisconsin-Madison

Rationale

The prevention of relapse in alcohol dependence is challenging. Meditation is a promising treatment for addictive disorders but has not been rigorously assessed. The goal of this study was to evaluate study methods and gather preliminary data on efficacy of meditation for alcohol relapse prevention . We hypothesized that meditation is effective for relapse prevention among alcohol dependent adults in early recovery.

Methods

Nineteen alcohol-dependent adults recruited from an intensive outpatient program (IOP) were enrolled in this ongoing 16-week study. The intervention included an eight-week meditation course and at-home meditation practice. Subjects' self-reported outcomes (alcohol consumption, drinking consequences, symptoms of stress, depression, anxiety, craving, subject satisfaction and adherence to study protocols) were assessed at baseline and every four weeks. Stress-responsive biomarkers (salivary cortisol, serum interleukin-6, IL-6) were obtained at baseline and at 16 weeks.

Results

Subjects were on average 38 years old; 53% were women, 84% were Caucasian; 47% had participated in outpatient treatment, 37% had undergone alcohol detoxification, and 32% had received residential treatment. At enrollment, subjects reported abstinence for 31 days and IOP of 24 days. 15/19 subjects have completed the meditation course and the eight-week assessment. Subjects "lost to follow-up" were similar to those continuing the study.

Compared to baseline, at 4 weeks, subjects' drinking frequency and quantity decreased, and severity of depression, anxiety, and stress improved (p<0.01); craving severity showed a tendency to improvement (p=0.08). These results were maintained at 8 weeks. At 8 weeks, subjects' degree of mindfulness increased (p<0.01). Protocol adherence was good; weekly meditation course attendance averaged 82% and subjects reported at-home meditation for 33 minutes per "meditating day" at 8 weeks. At baseline, salivary cortisol and IL-6 concentrations were higher than normative values. Subjects received "standard of care" therapy (IOP at baseline, and aftercare therapy at 4 and 8 weeks), supplemented by Alcoholic Anonymous meetings in 40% of the subjects.

After the meditation course, subjects rated it "very important" and as a "useful relapse prevention tool"; and were "very likely" to continue meditation. "Most valuable aspects" of meditation-related training included "gaining skills to reduce stress," "real-life skills for coping with craving," and "group support".

Conclusions

Results support the feasibility of the intervention and the possible efficacy of meditation as adjunctive therapy for relapse prevention in alcohol dependence.