A mindfulness-based intervention for Substance Use Disorder in a Brazilian vulnerable population: a feasibility mixed method study.
Mayra Pires Alves Machado, Emérita Sátiro Opaleye, Andre Bedendo, Sarah Bowen, Ana Regina Noto
Frontiers in Public Health 2024 DOI: 10.3389/fpubh.2024.1381489 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Mixed-methods feasibility study with pre-post pilot Pilot study Qualitative Peer reviewed |
|---|---|
| Sample size | 140 |
| Population | Socially vulnerable Brazilian adults with substance use disorder in outpatient treatment at Psychosocial Care Centers for Alcohol and Drugs (CAPS-ad) in São Paulo |
| Intervention | Mindfulness-Based Relapse Prevention (MBRP) |
| Topics | Addiction Meditation |
| Keywords | Feasibility Implementation Outpatient treatment Public health services Vulnerable population |
| Citations | 3 |
| Key points | MBRP as an adjunct to outpatient treatment for SUD is feasible and shows positive acceptance and mental health benefits in a socially vulnerable Brazilian population, despite high dropout and cultural misperceptions. |
Abstract
Substance Use Disorder (SUD) is a chronic condition that impacts various facets of an individual's life, and society as a whole. The Mindfulness-Based Relapse Prevention (MBRP) protocol is an innovative intervention that can help to prevent relapse, particularly when used as a post-treatment approach. However, although there is significant evidence of its effectiveness in studies from high-income countries (HICs), there is a dearth of studies examining its feasibility and efficacy in low- and middle-income countries (LMICs). Thus, this study investigates the feasibility of MBRP as an adjunct to outpatient treatment for SUD in a socially vulnerable Brazilian population. The study employed a mixed-methods design in eight Psychosocial Care Centers for Alcohol and Drugs (CAPS-ad) in the city of São Paulo, and involved 140 participants, 24 healthcare professionals and 7 CAPS-ad managers. In total, 17 MBRP intervention groups were conducted. The study assessed qualitative indicators of acceptability, demand, implementation, adaptation, integration, and limited efficacy testing through group interviews, in-depth interviews and field diary records. It also included limited efficacy testing of the protocol using a quantitative pre-post pilot study to investigate consumption behavior, using the Timeline Followback (TLFB) assessment method; depression, using the Center for Epidemiologic Studies Depression (CES-D) scale; anxiety, using the state trait anxiety index (STAXI-2); craving, using the Penn Alcohol Craving Scale (PACS); readiness to change, using the Readiness-to-Change Ruler (RCR); and severity of dependence, using the Severity of Dependence Scale (SDS). The qualitative data were triangulated with the quantitative data to comprehensively evaluate the feasibility of the intervention. The sample comprised socially vulnerable participants with a high dropout rate, primarily due to social factors. Despite facing challenges in respect of regular engagement and initial cultural misperceptions of meditation, the intervention showed positive acceptance and mental health benefits, including impacts on consumption behavior. The study emphasizes the importance of adapting the format of the protocol to better suit vulnerable populations, and to ensure its effective integration into the public healthcare system. Future research should explore protocol modifications, assess its effectiveness in different contexts, and conduct cost-benefit analyses for broader implementation.
Comparable studies
Other non-randomized and open-label trials on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction Psychiatrically healthy nicotine-dependent smokers | 2014 | Open-label pilot study | n = 15 |
| Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction Smokers | 2015 | Open-label pilot study | n = 15 |
| Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients | 1997 | Controlled clinical trial | n = 211 |
| First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Patients with alcohol use disorder (AUD) following community alcohol detoxification | 2021 | Open-label safety and tolerability proof-of-concept study | n = 14 |
| The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions Participants in a psilocybin-assisted treatment study for alcohol dependence | 2018 | Open-label pilot (proof-of-concept) study with qualitative content analysis | n = 17 |
Citations in the library
Cites 9
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
- Mindfulness-based interventions for addictive behaviors: Implementation issues on the road ahead. Psychology of Addictive Behaviors October 26, 2017
- Mindfulness-based interventions in inpatient treatment for Substance Use Disorders: A systematic review. Addictive Behaviors Reports November 11, 2022
- A systematic review of the barriers and facilitators to adherence to mindfulness-based cognitive therapy for those with chronic conditions. British Journal of Health Psychology October 31, 2022
and 4 more in the library