Mindfulness-Based Recovery in Veterans

Rates of substance use disorders (SUDS) are high among military personnel and Veterans. While
much research is focused on the acute care of SUDs, the risk of relapse to substance use
following treatment is high and attention to continuing care is critical. New continuing care
strategies targeting life-style change and improved coping mechanisms are important in
facilitating maintenance of abstinence, promoting rehabilitation and functional recovery for
Veterans with SUDs. Mindfulness-based relapse prevention (MBRP), a manualized treatment
integrating cognitive-behavioral relapse prevention therapy with mindfulness practices, has
shown promise in continuing care for SUDs. The proposed project will compare MBRP to a
12-Step Facilitation treatment as a continuing care strategy following primary treatment for
SUDs. Participants will be randomized to participate in 8-weeks of weekly 90-minute,
group-based MBRP or 12-Step Facilitation followed by a 10-month follow-up period with regular
assessments of substance use, mood/anxiety symptoms, quality of life and functional outcomes.
Two VAMC sites (Charleston and Tuscaloosa) with a history of successful collaboration will
work together to recruit an adequate sample size to address the primary study questions
within a 4-year period and to ensure generalizability of the results. If this trial
demonstrates that MBRP promotes sustained abstinence and improved functional outcomes, this
will provide a valuable treatment to facilitate rehabilitation and recovery for Veterans with
SUDs.

Inclusion Criteria:

1. Men and women military Veterans who have completed the Charleston or Tuscaloosa
Veterans Administration Medical Center (VAMC) intensive outpatient substance abuse
treatment program, a residential treatment program, or an intensive outpatient program
similar to the Charleston or Tuscaloosa VAMC program.

2. Able to comprehend English.

3. Meets DSM-V criteria for a current substance use disorder and have used substances in
the 30 days prior to treatment entry. Participants on medications targeting their
substance use must be stabilized on medications for at least 2 weeks before therapy
initiation.

4. May meet criteria for a mood, anxiety or other psychiatric disorder. Participants on
maintenance medications for a mood or anxiety disorder must be stabilized on
medications for at least 2 weeks before therapy initiation.

5. Able to adequately provide informed consent and function at an intellectual level
sufficient to allow accurate completion of all assessment instruments.

6. Willing to commit to 8 group therapy sessions, baseline, weekly and follow-up
assessments for 10-months after the end of treatment (12-month total).

Exclusion Criteria:

1. Active suicidal or homicidal ideation with a plan as this is likely to require
hospitalization or other interventions that could interfere with study participation.

2. Unstable psychiatric condition likely to require hospitalization or other
interventions that would interfere with study participation.

3. Unstable medical condition or one that may require hospitalization during the course
of the study.

4. Meets criteria for nicotine dependence only

5. Women who are pregnant