Ellington

UW scientists are testing a new approach to drug and alcohol addiction treatments, called mindfulness-based relapse prevention (MBRP), which melds Buddhist meditation techniques with traditional therapeutic approaches.

Many people use drugs or alcohol to self-medicate underlying psychiatric conditions like anxiety or depression, according to an article in the April 2007 issue of the Southern Medical Journal.

"We found that the number-one trigger for relapse for people who have been through treatment for alcohol and drugs is negative emotional states," said G. Alan Marlatt, a psychology professor and the director of the Addictive Behaviors Research Center. "If people are feeling bad, and if they've used drugs in the past to make themselves feel better in the short term by getting high, then, unless they've figured out or been taught other ways to cope with these negative emotions, they're a big trigger."

The MBRP program helps people cope with these emotions by teaching them Vipassana, a Buddhist meditation that emphasizes mindfulness, said Sarah Bowen, a psychology graduate student involved in the research. Mindfulness is the ability of the meditator to be "in the present moment," observing his or her thoughts without judging them, said Neharika Chawla, another psychology graduate student who works on the treatment.

Though the meditation has its roots in Eastern meditation, the treatment program is completely secular, Chawla said.

"The idea is for people to use mindfulness as a way of coping with urges, cravings, triggers and other stresses in their lives," Chawla said.

One mindfulness technique for coping with urges is called "urge surfing," Chawla said. In this process, when a person gets an urge to use drugs or alcohol, he or she is taught to imagine the urge as an ocean wave. The wave starts small but rises; the practitioner "surfs" the urge by using his or her breath as a surfboard, trying to maintain balance until the urge subsides, Marlatt said.

The group previously showed that Vipassana meditation reduced relapse and recidivism in a population of inmates from King County. In that study, non-violent offenders from a minimum- security prison — people incarcerated for drug-related offenses like DUI, drug possession, sales or prostitution — chose to be placed in a control group or enrolled in a 10-day, intensive, silent meditation retreat, Marlatt said.

"We found people who took this course were just doing much better on all outcome measures," Marlatt said. "They had significantly less alcohol and drug use, less smoking, less depression, less anxiety and were more optimistic about future life opportunities."

However, because many are unable to commit 10 days to a silent meditation retreat, the researchers have incorporated the meditation techniques into an eight-week, group treatment session that meets once a week for two hours, Chawla said.

With a grant from the National Institute on Drug Abuse (NIDA), the group is evaluating the treatment's effectiveness in a small pilot study at A Positive Alternative Womens Center, a Seattle-based drug treatment program, Marlatt said.

Another larger study, which will be completed in June 2008, is being conducted with the Recovery Centers of King County. In this study, 150 subjects — many of whom have been mandated to treatment by the courts — will be randomly assigned to either an MBRP group or a traditional treatment program like Alcoholics Anonymous (AA).

If the results of the studies are positive, they may provide more options for people struggling with addiction, especially lower-income people who often aren't given much choice in their treatment programs, Chawla said.

"Right now when you're mandated to treatment, you tend to get put into a 12-step, AA-type group, and that is a good fit for some people, but it is not a good fit for everyone," Bowen said.

Because AA and Narcotics Anonymous are based in Christianity, these groups often encourage people to appeal to a higher power for help with addiction. Many, however, want to feel more in control of the process, Chawla said.

"We're just giving them a consumer choice," Marlatt said. "We're saying, if the 12-step doesn't work, what abut the Buddhist eight-fold path?"

Reach columnist Tia Ghose at news@thedaily.washington.edu.