Fidelity is crucial to the effectiveness of mindfulness-based interventions, and providers must undergo a high level of training with an intensive curriculum (for instance, Mindfulness-Oriented Recovery Enhancement requires a two-day workshop followed by several weeks of additional training). The training requirements can be especially difficult for busy providers with heavy caseloads. A survey of 103 substance use professionals found that the need for training was the most significant perceived barrier to the implementation of mindfulness-based interventions.

Mindfulness-based interventions for substance use have primarily been studied as adjunctive to other treatments such as methadone or buprenorphine. To see the full effects, providers will likely need to deliver additional treatments to their patients, adding to their regular workloads.

Resistance to manualized protocols may be a barrier to the delivery of mindfulness-based interventions for substance use. A study of substance use professionals found that about a third reported using mindfulness with their patients, but that only 7% reported using a research-based manual.