Mindfulness-Oriented Recovery Enhancement Reduces Illicit Substance Craving Among People with Alcohol Use Disorder and Polysubstance Use.
Laura Gurrieri, Margaret C. Wardle, Eric L Garland
Substance Use & Misuse September 2, 2025 DOI: 10.1080/10826084.2025.2525379 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized controlled trial Pilot study Peer reviewed |
|---|---|
| Sample size | 50 |
| Population | Adults with alcohol use disorder who also used cocaine and/or cannabis |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Duration | Ten sessions |
| Topics | Addiction Cannabis Meditation |
| Keywords | Humans Alcoholism Cocaine-related disorders Marijuana abuse Treatment outcome Psychotherapy, group Adult Middle aged Female Craving Cognitive behavioral therapy Polysubstance |
| Key findings | Participants randomized to Mindfulness-Oriented Recovery Enhancement reported significantly greater reductions in illicit substance craving across a cue-reactivity protocol from pre- to post-treatment compared with a supportive group psychotherapy control, though the effect did not significantly vary by cue condition. The authors suggest MORE may reduce illicit substance craving in patients with polysubstance use and alcohol use disorder and warrants full-scale randomized trials. |
Abstract
Background: Polysubstance use is common in alcohol use disorder (AUD) and associated with poor treatment outcomes. Cannabis and cocaine often co-used with alcohol, have no approved medication treatments and respond poorly to common behavioral treatments. Thus, treatments that can reduce use of these substances alongside AUD are critically needed.
Objectives: We tested whether Mindfulness-Oriented Recovery Enhancement (MORE), an evidence-based group therapy approach combining mindfulness, cognitive-behavioral techniques, and savoring natural rewards could simultaneously reduce cravings for cannabis and/or cocaine. Given MORE's demonstrated efficacy for treating other addictive behaviors, we hypothesized it would reduce craving for cannabis and/or cocaine in people with AUD.
Methods: Participants (N = 50) were adults with AUD who also used cocaine and/or cannabis. Participants were randomly assigned to ten-sessions of either MORE or supportive group (SG) psychotherapy control condition, both targeting at AUD. Illicit substance craving was assessed before and after treatment during a cue reactivity protocol consisting of a resting baseline, 5-min stress imagery exposure, 5-min alcohol image exposure, and 5-min recovery period.
Results: Results revealed a significant Group-X Time interaction, F = 7.06, p=.008, indicating that patients randomized to MORE reported significantly greater reductions in illicit substance craving across the entire cue-reactivity protocol from pre- to post-treatment. However, the Group-X Time-X Condition interaction was nonsignificant (p=.61), indicating that the effect of MORE did not significantly vary by condition.
Conclusion: Results from this pilot study suggest that MORE may reduce illicit substance craving in patients with polysubstance use and AUD. MORE should be further evaluated in full-scale randomized clinical trials for cannabis and cocaine use disorder.
Comparable studies
Other randomized controlled trials on cannabis for addiction, most cited first.
Citations in the library
Cites 7
- A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. American Journal of Psychiatry June 24, 2019
- Telehealth Mindfulness-Oriented Recovery Enhancement vs Usual Care in Individuals With Opioid Use Disorder and Pain: A Randomized Clinical Trial. JAMA Psychiatry April 1, 2024
- Mindfulness-Oriented Recovery Enhancement for Veterans and Military Personnel on Long-Term Opioid Therapy for Chronic Pain: A Randomized Clinical Trial American Journal of Psychiatry January 10, 2024
- Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials. Mindfulness September 15, 2022
- Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care JAMA Internal Medicine February 28, 2022
and 2 more in the library