How Effective Are Mindfulness-Based Interventions (MBIs) for the Treatment of Substance Use Disorders (SUDs), Relapse Prevention, and Craving: An Umbrella Review Article.

An umbrella review of 11 systematic reviews and meta-analyses published between 2017 and 2026 assessed the effectiveness of mindfulness-based interventions (MBIs) for substance use disorder treatment, relapse prevention, and craving reduction. The evidence suggests that MBIs, including Mindfulness-Based Relapse Prevention and Mindfulness-Oriented Recovery Enhancement, provide preliminary support for reducing relapse (effect sizes: d = 0.45–0.78) and craving for alcohol, opioids, and stimulants (Hedges' g = 0.52–0.71). Neuroimaging findings indicated increased prefrontal activation and reduced insular hyperactivity. Heterogeneity and study quality should be considered; standardization and longer follow-up are recommended for clinical application.

Study at a glance

Abstract

Substance use disorders (SUDs) affect the lives of more than 35 million people worldwide, according to 2019 data from the United Nations Office on Drugs and Crime. Current evidence suggests that MBIs may mitigate the harmful psychosocial effects associated with SUDs. Although MBIs have been extensively studied for efficacy, there remains a growing need to synthesize evidence from relevant systematic reviews and meta-analyses to better understand their use in relapse prevention and craving reduction. This umbrella review aimed to assess the available evidence on the effectiveness of MBIs for SUD treatment, relapse prevention, and craving reduction. Following an extensive search of scientific databases, including PubMed, PsycINFO, EMBASE, Cochrane Library, and Web of Science (last search: May 15, 2026), using keywords such as MBIs, SUDs, relapse, craving, addiction, systematic reviews, and meta-analyses, 45 papers were initially identified. After removing duplicates and screening, 11 systematic reviews and meta-analyses were selected for inclusion. These 11 reviews, published between 2017 and 2026, were critically evaluated to assess the efficacy of MBIs for SUDs treatment, craving, and relapse prevention, to examine underlying mechanisms, and to compare intervention types. The results aligned with evidence that MBIs, including Mindfulness-Based Relapse Prevention (MBRP), Mindfulness-Oriented Recovery Enhancement (MORE), and manualized treatment, provide preliminary support for reducing relapse (effect sizes: d = 0.45-0.78) and craving for alcohol, opioids, and stimulants (Hedges' g = 0.52-0.71). Neuroimaging findings revealed differences in activity in regions involved in craving and self-regulation, with convergent evidence from multiple reviews indicating increased prefrontal activation and reduced insular hyperactivity. The available evidence supports relapse prevention and craving reduction, although heterogeneity and study quality should be considered. Standardization of protocols and follow-up over prolonged periods is recommended to enable clinical application.