A mindfulness-based therapy designed for alcohol use disorder also significantly reduced cravings for cannabis and cocaine in a pilot trial of 50 adults with polysubstance use.
Addiction counselors, mindfulness-based intervention researchers, clinicians treating polysubstance use
What the researchers found
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.
Why it matters
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.
The numbers in context
50 adults with AUD + cannabis/cocaine use; 10 sessions; significant Group x Time interaction (F=7.06, p=0.008); effect consistent across stress and cue conditions (interaction p=0.61, non-significant, meaning benefit did not vary by condition)
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Preliminary: small pilot RCT with craving as a surrogate outcome rather than actual use reduction.
When this study was published
2025 publication
The bigger picture
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.
Questions still open
- Would a larger trial confirm these craving reduction effects?
- Does reduced craving from MORE translate to reduced cannabis and cocaine use over time?
Read the original research
Mindfulness-Oriented Recovery Enhancement Reduces Illicit Substance Craving Among People with Alcohol Use Disorder and Polysubstance Use.
Substance use & misuse, 60(13), 1964-1968
Citation
Gurrieri, Laura; Wardle, Margaret C; Garland, Eric L. (2025). Mindfulness-Oriented Recovery Enhancement Reduces Illicit Substance Craving Among People with Alcohol Use Disorder and Polysubstance Use.. Substance use & misuse, 60(13), 1964-1968. https://doi.org/10.1080/10826084.2025.2525379
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