Mindfulness-Based Therapy Reduced Cannabis and Cocaine Cravings in People with Alcohol Problems

In a randomized pilot trial of 50 adults with AUD who also used cannabis and/or cocaine, Mindfulness-Oriented Recovery Enhancement (MORE) produced significantly greater reductions in illicit substance craving compared to supportive group therapy (F=7.06, p=0.008). The effect was consistent across a stress-and-cue reactivity protocol. MORE combines mindfulness training, cognitive-behavioral techniques, and practices for savoring natural rewards.

Randomized controlled pilot trial. 50 adults with AUD and concurrent cannabis/cocaine use assigned to 10 sessions of MORE or supportive group psychotherapy. Craving assessed before and after treatment during a cue-reactivity protocol with resting baseline, stress imagery, alcohol image exposure, and recovery period.

Cannabis and cocaine have no approved medication treatments and respond poorly to standard behavioral therapies. Finding that a mindfulness-based approach can reduce cravings across multiple substances simultaneously could simplify treatment for polysubstance users.

Polysubstance use is the norm in addiction treatment settings, not the exception. Therapies that address multiple substance cravings simultaneously are more practical and efficient than substance-specific approaches.

Pilot study with small sample size (N=50). Cannot determine which component of MORE (mindfulness, CBT, savoring) drove the effect. Short-term craving reduction in a lab protocol may not predict real-world use reduction. The therapy targeted AUD, so cannabis/cocaine effects are secondary outcomes.