Children Born to Heroin-Addicted Mothers: What’s the Outcome 25 Years Later?

Abstract

Mindfulness is one of the fastest growing areas of psychological research and over 70% of general practitioners in the United Kingdom now believe that mindfulness/meditation can be beneficial for patients with mental health issues [1]. In a previous issue of the Journal of Addiction Research and Therapy, Penberthy focused on an intervention known as mindfulness-based relapse prevention [MBRP] and argued that MBRP appears to be an effective treatment for reducing substance use relapse [2]. Following a critical review of the latest empirical and clinical evidence, we argue that there may also be applications for mindfulness approaches in the treatment of non-chemical (i.e., behavioural) addictions. Mindfulness is a form of meditation that derives from Buddhist practice. We have previously defined mindfulness as the process of engaging a full, direct, and active awareness of experienced phenomena that is spiritual in aspect and that is maintained from one moment to the next [3]. As part of the practice of mindfulness, a 'meditative anchor' , such as observing the breath, is typically used to aid concentration and to help maintain an open-awareness of present moment sensory and cognitive-affective experience [1]. Within mental health and addiction treatment settings, mindfulness-based interventions (MBIs) are generally delivered in a secular eight-week format and invariably comprise the following: (i) weekly sessions of 90-180 minutes duration, (ii) a taught psycho-education component, (iii) guided mindfulness exercises, (iv) a CD of guided mindfulness and/or meditation exercises to facilitate daily self-practice, and (v) varying degrees of one-to-one discussion-based therapy with the program instructor. Examples of MBIs used in behavioral addiction treatment studies include Mindfulness-Based Cognitive Therapy, Mindfulness-Enhanced Cognitive Behavior Therapy, Mindfulness-Based Relapse Prevention, Mindfulness-Based Stress Reduction, and Meditation Awareness Training [4-6]. Studies investigating the role of mindfulness in the treatment of behavioral addictions have – to date – primarily focused on problem and/or pathological gambling. Cross-sectional studies have shown that levels of dispositional mindfulness in problem gamblers are inversely associated with gambling severity [7], thought suppression [8], and psychological distress [9]. Recent clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change in problem gambling individuals. Published case studies include: (i) a male in his sixties addicted to offline roulette playing [10], (ii) a 61-year old female (with comorbid anxiety and depression) addicted to slot machine gambling (treated with a modified version of Mindfulness-Based Cognitive Therapy) [6], and (iii) a 32-year old female (with co-occurring schizophrenia) addicted to online slot-machine playing (treated with a modified version of Meditation Awareness Training) [11]. Additionally, a recent controlled study showed that problem gamblers that received Mindfulness-Enhanced Cognitive Behavior Therapy demonstrated significant improvements over wait-list control participants in levels of gambling severity, gambling urges, and emotional distress [5].