A number of controlled research studies have found that mindfulness-based interventions for substance use produce significant reductions in alcohol, cocaine, nicotine, and opioid use, measured by the number of days of use. For the treatment of opioid use, mindfulness-based interventions have been shown to be an effective adjunct to medication for opioid use disorder, but there is limited data supporting its use as a standalone treatment.

Studies of mindfulness-based interventions frequently assess cravings, using various self-report scales and questionnaires. A meta-analysis found that mindfulness-based interventions had a significant effect on craving post-treatment with an effect size estimated at -0.70, which corresponds with a medium to large effect. However, there was a high degree of inconsistency across studies and a high risk of bias, so the authors noted that they were “unable to conclude that there is a medium to large effect size” and called for additional research on craving reduction.

A systematic review of studies of Mindfulness-Based Relapse Prevention (MBRP) identified one study that examined the effect of MBRP on impulsivity, a significant risk factor for the onset of substance use disorders and the likelihood of relapse. The study found that receipt of MBRP was associated with reductions in impulsivity relative to treatment as usual among patients with opioid use disorder.

Mindfulness-based interventions have been found to increase patient use of approach coping skills (skills that help the patient to actively confront the stressful situation) rather than avoidance coping skills (skills that help the patient to avoid the stressful situation). In one clinical trial of Mindfulness-Based Relapse Prevention (MBRP), increases in approach coping skills predicted reductions in substance use and substance-related problems over the 12 months following treatment. Notably, increases in approach coping explained the therapeutic benefits of MBRP among individuals with high symptoms of depression, anxiety, and/or PTSD.

Mindfulness-based interventions have been found to be effective at treating symptoms of depression and anxiety in patients with substance use disorder. In several studies of Mindfulness-Based Relapse Prevention, substance use disorder patients with high baseline levels of depression or anxiety showed the most significant reduction in symptoms after treatment.

Mindfulness-based interventions have also been found to reduce the risk of relapse, as measured by patient self-report or urinalysis. In one trial, patients who received mindfulness-based relapse prevention experienced similar outcomes at six months post-treatment to those who received cognitive-behavioral relapse prevention, and both relapse prevention conditions reported less risk of relapse to substance use (and lower overall rates of substance use) compared to individuals receiving treatment as usual.