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Addictive Behavior Change and Mindfulness-Based Interventions: Current Research and Future Directions


Purpose of Review

Addictive behaviors are difficult to change and result in high rates of relapse following change attempts. A number of effective treatment approaches have been developed to treat addictive behaviors (e.g., cognitive behavioral therapies). More recently, there has been an increase in the development and evaluation of mindfulness-based interventions for addictive behaviors. This article discusses the history of mindfulness-based interventions for addictive behaviors and recent advances in treatment.

Recent Findings

Mindfulness-based interventions are as effective as existing evidence-based treatments for addictive behaviors. Further understanding of the neurobiological changes that occur could help identify the components of mindfulness-based interventions that are most helpful and which individuals may benefit most from mindfulness-based intervention.


Additional large-scale randomized controlled trials are needed for a better understanding of the effectiveness of mindfulness-based interventions. Future research should look at optimizing mindfulness-based interventions for specific settings and patient populations, as well as dissemination and implementation.

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  1. 1.

    Kabat-Zinn JCN-BMK 1994. Wherever you go, there you are: mindfulness meditation in everyday life. 1st ed. New York: Hyperion; 1994.

  2. 2.

    Nhất Hạnh TCN-B. N 1999. The heart of the Buddha’s teaching: transforming suffering into peace, joy & liberation: the four noble truths, the noble eightfold path, and other basic Buddhist teachings. 1st Broadw. New York: Broadway Books; 1999.

  3. 3.

    Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, et al. Mindfulness: a proposed operational definition. Clin Psychol Sci Pract. 2004;11:230–41.

  4. 4.

    Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med [Internet]. 1985;8:163–90 Available from: http://link.springer.com/10.1007/BF00845519.

  5. 5.

    Kabat-Zinn J, Lipworth L, Burney R, Sellers W, Brew M. Reproducibility and four year follow-up of a training program in mindfulness meditation for the self-regulation of chronic pain. Pain [Internet]. 1984;18:S303 Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006396-198401001-00451.

  6. 6.

    Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry [Internet]. 1982;4:33–47 Available from: https://linkinghub.elsevier.com/retrieve/pii/0163834382900263.

  7. 7.

    Segal ZV, Williams JMG, Teasdale JDCN-R. S 2002. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press; 2002.

  8. 8.

    Linehan M. Cognitive-behavioral treatment of borderline personality disorder. In: Diagnosis Treat. Ment. Disord. CN - RC569.5.B67 L56 1993. New York: Guilford Press; 1993.

  9. 9.

    Hayes SC, Strosahl K, Wilson KGCN-RCH 1999. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press. p. 1999.

  10. 10.

    Abuse NI on D. Principles of drug addiction treatment: a research based Guide (3rd Ed.) [Internet]. NIH Publ. Rockville, MD: National Institute on Drug Abuse; 2018.

  11. 11.

    Bowen S, Chawla N, Marlatt GACN-R. B 2011. Mindfulness-based relapse prevention for addictive behaviors: a clinician’s guide. New York: Guilford Press; 2011.

  12. 12.

    Witkiewitz K, Marlatt GA, Walker D. Mindfulness-based relapse prevention for alcohol and substance use disorders. J Cogn Psychother [Internet]. 2005;19:211–28 Available from: http://connect.springerpub.com/lookup/doi/10.1891/jcop.2005.19.3.211.

  13. 13.

    Zgierska AE, Shapiro J, Burzinski CA, Lerner F, Goodman-Strenski V. Maintaining treatment fidelity of mindfulness-based relapse prevention intervention for alcohol dependence: a randomized controlled trial experience. Evidence-Based Complement Altern Med [Internet]. 2017;2017:1–12 Available from: https://www.hindawi.com/journals/ecam/2017/9716586/.

  14. 14.

    Brewer JA, Sinha R, Chen JA, Michalsen RN, Babuscio TA, Nich C, et al. Mindfulness training and stress reactivity in substance abuse: results from a randomized, controlled stage I pilot study. Subst Abus [Internet]. 2009;30:306–17.

  15. 15.

    Garland EL, Manusov EG, Froeliger B, Kelly A, Williams JM, Howard MO. Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. J Consult Clin Psychol [Internet]. 2014;82:448–59 Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0035798.

  16. 16.

    Marlatt A. Substance abuse treatment and the stages of change. Addiction [Internet]. 2002;97:607–8 Available from: http://doi.wiley.com/10.1046/j.1360-0443.2002.t01-8-00166.x.

  17. 17.

    Tiffany ST, Drobes DJ. Imagery and smoking urges: the manipulation of affective content. Addict Behav [Internet]. 1990;15:531–9 Available from: https://linkinghub.elsevier.com/retrieve/pii/030646039090053Z.

  18. 18.

    Li W, Howard MO, Garland EL, McGovern P, Lazar M. Mindfulness treatment for substance misuse: a systematic review and meta-analysis. J Subst Abuse Treat [Internet]. 2017;75:62–96 Available from: https://linkinghub.elsevier.com/retrieve/pii/S0740547216302409.

  19. 19.

    Godfrey KM, Gallo LC, Afari N. Mindfulness-based interventions for binge eating: a systematic review and meta-analysis. J Behav Med [Internet]. 2015;38:348–62 Available from: http://link.springer.com/10.1007/s10865-014-9610-5.

  20. 20.

    Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Wampold BE, Kearney DJ, et al. Mindfulness-based interventions for psychiatric disorders: a systematic review and meta-analysis. Clin Psychol Rev [Internet]. 2018;59:52–60 Available from: https://linkinghub.elsevier.com/retrieve/pii/S0272735817303847.

  21. 21.

    Brewer JA, Garrison KA. The posterior cingulate cortex as a plausible mechanistic target of meditation: findings from neuroimaging: the PCC as a target of meditation. Ann N Y Acad Sci [Internet]. 2014;1307:19–27 Available from: http://doi.wiley.com/10.1111/nyas.12246.

  22. 22.

    McConnell PA, Froeliger B. Mindfulness, mechanisms and meaning: perspectives from the cognitive neuroscience of addiction. Psychol Inq [Internet]. 2015;26:349–57.

  23. 23.

    Garland EL, Froeliger B, Howard MO. Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Front Psychiatry [Internet]. 2014;4:173.

  24. 24.

    Garland EL, Roberts-Lewis A, Tronnier CD, Graves R, Kelley K. Mindfulness-oriented recovery enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: proximal outcomes from a pragmatic randomized trial. Behav Res Ther [Internet]. 2016;77:7–16 Available from: https://linkinghub.elsevier.com/retrieve/pii/S0005796715300619.

  25. 25.

    Himelstein S, Saul S, Garcia-Romeu A. Does mindfulness meditation increase effectiveness of substance abuse treatment with incarcerated youth? A pilot randomized controlled trial. Mindfulness (N Y) [Internet]. 2015;6:1472–80 Available from: http://link.springer.com/10.1007/s12671-015-0431-6.

  26. 26.

    Alizadehgoradel J, Imani S, Nejati V, Fathabadi J. Mindfulness-based substance abuse treatment (MBSAT) improves executive functions in adolescents with substance use disorders. Neurol Psychiatry Brain Res [Internet]. Imani, Saeed, Department of Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Shahid Beheshti University, P.O. Box 1983963113, 193954716, Tehran, Iran: Elsevier Science; 2019;34:13–21. Available from: http://offcampus.lib.washington.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2019-73994-003&site=ehost-live

  27. 27.

    Davis JP, Barr N, Dworkin ER, Dumas TM, Berey B, DiGuiseppi G, et al. Effect of mindfulness-based relapse prevention on impulsivity trajectories among young adults in residential substance use disorder treatment. Mindfulness (N Y) [Internet]. Davis, Jordan P., Department of Children, Youth, and Families Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th Street, Los Angeles, CA, US, 90089: Springer; 2019; Available from: http://offcampus.lib.washington.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2019-25673-001&site=ehost-live

  28. 28.

    Valls-Serrano C, Caracuel A, Verdejo-Garcia A. Goal management training and mindfulness meditation improve executive functions and transfer to ecological tasks of daily life in polysubstance users enrolled in therapeutic community treatment. Drug Alcohol Depend [Internet]. 2016;165:9–14 Available from: https://linkinghub.elsevier.com/retrieve/pii/S0376871616301156.

  29. 29.

    Bowen S, Marlatt A. Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychol Addict Behav [Internet]. 2009;23:666–71 Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0017127.

  30. 30.

    Davis JM, Fleming MF, Bonus KA, Baker TB. A pilot study on mindfulness based stress reduction for smokers. BMC Complement Altern Med [Internet]. 2007;7(2) Available from: https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-7-2.

  31. 31.

    Davis JM, Goldberg SB, Anderson MC, Manley AR, Smith SS, Baker TB. Randomized trial on mindfulness training for smokers targeted to a disadvantaged population. Subst Use Misuse [Internet]. 2014;49:571–85.

  32. 32.

    Davis JM, Manley AR, Goldberg SB, Smith SS, Jorenby DE. Randomized trial comparing mindfulness training for smokers to a matched control. J Subst Abuse Treat [Internet]. 2014;47:213–21.

  33. 33.

    Kober H, Brewer JA, Height KL, Sinha R. Neural stress reactivity relates to smoking outcomes and differentiates between mindfulness and cognitive-behavioral treatments. Neuroimage [Internet]. 2017;151:4–13.

  34. 34.

    Ruscio AC, Muench C, Brede E, Waters AJ. Effect of brief mindfulness practice on self-reported affect, craving, and smoking: a pilot randomized controlled trial using ecological momentary assessment. Nicotine Tob Res [Internet]. 2015:ntv074 Available from: https://academic.oup.com/ntr/article-lookup/doi/10.1093/ntr/ntv074.

  35. 35.

    Singh NN, Lancioni GE, Myers RE, Karazsia BT, Winton ASW, Singh J. A randomized controlled trial of a mindfulness-based smoking cessation program for individuals with mild intellectual disability. Int J Ment Health Addict [Internet]. 2014;12:153–68 Available from: http://link.springer.com/10.1007/s11469-013-9471-0.

  36. 36.

    Vidrine JI, Spears CA, Heppner WL, Reitzel LR, Marcus MT, Cinciripini PM, et al. Efficacy of mindfulness-based addiction treatment (MBAT) for smoking cessation and lapse recovery: a randomized clinical trial. J Consult Clin Psychol [Internet]. 2016;84:824–38.

  37. 37.

    Maglione MA, Maher AR, Ewing B, Colaiaco B, Newberry S, Kandrack R, et al. Efficacy of mindfulness meditation for smoking cessation: a systematic review and meta-analysis. Addict Behav [Internet]. 2017;69:27–34 Available from: https://linkinghub.elsevier.com/retrieve/pii/S030646031730031X.

  38. 38.

    Bowen S, Chawla N, Collins SE, Witkiewitz K, Hsu S, Grow J, et al. Mindfulness-based relapse prevention for substance use disorders: a pilot efficacy trial. Subst Abus. 2009;30:295–305.

  39. 39.

    Mermelstein LC, Garske JP. A brief mindfulness intervention for college student binge drinkers: a pilot study. Psychol Addict Behav [Internet]. 2015;29:259–69 Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/adb0000040.

  40. 40.

    Szeto EH, Schoenmakers TM, van de Mheen D, Snelleman M, Waters AJ. Associations between dispositional mindfulness, craving, and drinking in alcohol-dependent patients: an ecological momentary assessment study. Psychol Addict Behav [Internet]. 2019;33:431–41 Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/adb0000473.

  41. 41.

    Enkema MC, Bowen S. Mindfulness practice moderates the relationship between craving and substance use in a clinical sample. Drug Alcohol Depend [Internet]. 2017;179:1–7 Available from: https://linkinghub.elsevier.com/retrieve/pii/S0376871617303137.

  42. 42.

    Imani S, Atef Vahid MK, Gharraee B, Noroozi A, Habibi M, Bowen S. Effectiveness of mindfulness-based group therapy compared to the usual opioid dependence treatment. Iran J Psychiatry [Internet]. 2015;10:175–84 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26877751.

  43. 43.

    Garland EL, Hanley AW, Kline A, Cooperman NA. Mindfulness-oriented recovery enhancement reduces opioid craving among individuals with opioid use disorder and chronic pain in medication assisted treatment: ecological momentary assessments from a stage 1 randomized controlled trial. Drug Alcohol Depend [Internet]. 2019;203:61–5 Available from: http://www.ncbi.nlm.nih.gov/pubmed/31404850.

  44. 44.

    Vowles KE, Witkiewitz K, Cusack KJ, Gilliam WP, Cardon KE, Bowen S, et al. Integrated behavioral treatment for veterans with co-morbid chronic pain and hazardous opioid use: a randomized controlled pilot trial. J Pain Off J Am Pain Soc [Internet]. 2019.

  45. 45.

    Edwards KA, Vowles KE, Witkiewitz K. Co-use of alcohol and opioids. Curr Addict Reports [Internet]. 2017;4:194–9 Available from: http://link.springer.com/10.1007/s40429-017-0147-x.

  46. 46.

    Gearhardt AN, Davis C, Kuschner R, Brownell KD. The addiction potential of hyperpalatable foods. Sharjah: Bentham Science Publishers.

  47. 47.

    Gearhardt AN, Boswell RG, White MA. The association of “food addiction” with disordered eating and body mass index. Eat Behav Elsevier Ltd. 2014;15:427–33.

  48. 48.

    Kristeller J, Wolever RQ, Sheets V. Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: a randomized clinical trial. Mindfulness (N Y) [Internet]. 2014;5:282–97 Available from: http://link.springer.com/10.1007/s12671-012-0179-1.

  49. 49.

    Levoy E, Lazaridou A, Brewer J, Fulwiler C. An exploratory study of mindfulness based stress reduction for emotional eating. Appetite [Internet]. 2017;109:124–30 Available from: https://linkinghub.elsevier.com/retrieve/pii/S019566631630825X.

  50. 50.

    Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav [Internet]. 2014;15:197–204 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24854804.

  51. 51.

    McIntosh CC, Crino RD, O’Neill K. Treating problem gambling samples with cognitive behavioural therapy and mindfulness-based interventions: a clinical trial. J Gambl Stud [Internet]. 2016;32:1305–25 Available from: http://www.ncbi.nlm.nih.gov/pubmed/27040973.

  52. 52.

    Toneatto T, Pillai S, Courtice EL. Mindfulness-enhanced cognitive behavior therapy for problem gambling: a controlled pilot study. Int J Ment Health Addict [Internet]. 2014;12:197–205 Available from: http://link.springer.com/10.1007/s11469-014-9481-6.

  53. 53.

    Shead NW, Champod AS, MacDonald A, et al. Int J Ment Health Addict [Internet]. 2019; Available from: http://link.springer.com/10.1007/s11469-019-00133-x.

  54. 54.

    Maynard BR, Wilson AN, Labuzienski E, Whiting SW. Mindfulness-based approaches in the treatment of disordered gambling: a systematic review and meta-analysis. Res Soc Work Pract [Internet]. 2018;28:348–62 Available from: http://journals.sagepub.com/doi/10.1177/1049731515606977.

  55. 55.

    Kuss DJ, Griffiths MD. Internet gaming addiction: a systematic review of empirical research. Int. J. Ment. Health Addict. 2012:278–96.

  56. 56.

    Smyth JM. Beyond self-selection in video game play: an experimental examination of the consequences of massively multiplayer online role-playing game play. Cyberpsychology Behav. 2007;10:717–21.

  57. 57.

    Chappell D, Eatough V, Davies MNO, Griffiths M. EverQuest - it’s just a computer game right? An interpretative phenomenological analysis of online gaming addiction. Int J Ment Health Addict. 2006;4:205–16.

  58. 58.

    Li W, Garland EL, Mcgovern P, O’brien JE, Tronnier C, Howard MO. Mindfulness-oriented recovery enhancement for internet gaming disorder in U.S. adults: a stage I randomized controlled trial. Psychol Addict Behav. 2017;31:393–402.

  59. 59.

    Li W, Garland EL, Howard MO. Therapeutic mechanisms of mindfulness-oriented recovery enhancement for internet gaming disorder: reducing craving and addictive behavior by targeting cognitive processes. J Addict Dis [Internet]. Li, Wen, Rutgers, The State University of New Jersey, School of Social Work, 536 George Street, New Brunswick, NJ, US, 08901: Taylor & Francis. 2018;37:5–13.

  60. 60.

    Yao YW, Chen PR, Li C, Shan R, Hare TA, Li S, et al. Combined reality therapy and mindfulness meditation decrease intertemporal decisional impulsivity in young adults with Internet gaming disorder. Comput Human Behav [Internet]. Elsevier Ltd. 2017;68:210–6. https://doi.org/10.1016/j.chb.2016.11.038.

  61. 61.

    Roos CR, Bowen S, Witkiewitz K. Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention. J Consult Clin Psychol [Internet]. 2017;85:1041–51.

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Correspondence to Frank J. Schwebel.

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This article is part of the Topical Collection on Emotion and Addiction

FJS was supported by a training grant (T32AA018108) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

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Schwebel, F.J., Korecki, J.R. & Witkiewitz, K. Addictive Behavior Change and Mindfulness-Based Interventions: Current Research and Future Directions. Curr Addict Rep (2020). https://doi.org/10.1007/s40429-020-00302-2

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  • Mindfulness
  • Mindfulness-based interventions
  • Addictive behavior
  • Behavior change