Calming the Craving
UT researchers test stress-reduction techniques to overcome addiction
He gave his mother his word that he would clean up his act. But as he accepted $100 in travel money and a train ticket that would get him to a drug and alcohol recovery program in Texas, he knew he wasn’t ready to give up his habits.
Jason was a 29-year-old addict, a liar and a homeless thief with a criminal record. He only agreed to enter rehab because his mother wouldn’t let him back in the house. It was snowing in Detroit. It was too cold, and he was too exhausted from the drugs to be living on the street.
He made it to Chicago before he blew his mother’s cash on cocaine. Then he befriended a passenger on the train who was willing to share his liquor. “I got high and drunk on the way to treatment,” Jason says. “Needless to say, when I walked in the door, I had 37 cents left and was feeling extra crappy.”
As with previous trips to rehab, his plan was to get cleaned up just enough to start the spiral toward rock bottom all over again. He didn’t know it then, but accepting an invitation to participate in a study led by faculty at The University of Texas Health Science Center at Houston School of Nursing was about to help him breathe life into a new way of living.
Marianne T. Marcus, EdD, RN, FAAN, director of the university’s Center for Substance Abuse Education, Prevention and Research, was testing whether Mindfulness-Based Stress Reduction helped residents in a therapeutic community at Cenikor Foundation manage their recovery.
As a participant, Jason would learn breathing techniques, yoga poses and other methods of stress reduction. Soon, every breath, every realization that he needed to focus on the present rather than dwell on his mistakes, helped him gain a deeper understanding of himself and his ability to remain sober.
“It was so simple, but it was life-changing,” Jason says.
Marcus says the research program, supported by a National Institute on Drug Abuse grant, was based on the program of Mindfulness, a form of meditation founded by Jon Kabat- Zinn.
“The key is to be in the present moment, which is so critically important in recovery,” Marcus says. “You can’t avoid things and say, `Oh, I’ll just deal with that later.’ This forces you to acknowledge how good or bad it is at this very moment and realize that it is not permanent.”
Mindfulness is an exercise in attention and offers tools for coping with stressful situations that come with everyday life – and just as effectively, those associated with addiction and its heightened stress, Marcus says.
Her recent study findings, which were published earlier this year in The American Journal of Drug and Alcohol Abuse, showed that participants in Mindfulness-Based Stress Reduction decreased their stress two to three times faster than fellow residents in the early stages of an 18-month therapeutic community treatment program. High stress levels on admission to this behavioral modification program correlate with early dropout, so this is an important finding, Marcus says. Her collaborators include F. Gerald Moeller, MD, and Joy Schmitz, PhD, of The University of Texas Medical School at Houston.
Jason says those first three months are often the hardest and being able to tap into these stress-reduction techniques helped him through those difficult times and can continue to help him even today.
“The stress that occurs with recovery is tremendous,” he says. “For 10 years, I had been reaching for drugs and alcohol to deal with life. This gave me something else.”
For him, simply listening to the soothing voice on the instructional CDs helped to keep him centered in the present. “’Now bring the focus back to the breath.’ That’s what the voice says. I still listen to those CDs, and even when I’m not, sometimes I think to myself, ‘Now bring the focus back to the breath,’” Jason says. “You’d be surprised how much it helps.”
He used a technique called the body scan. “You close your eyes and focus on the different parts of your body. Wiggling your toes, sensing the feeling in your arms and legs – it’s all very calming and makes you very aware of the moment,” he says. He also did yoga as part of the Mindfulness-Based Stress Reduction. “There was the Cat Cow pose, which was goofy looking, so that was everyone’s favorite,” he says.
Marcus says, “This is not THE answer, but it appears to be an important part of the treatment. If we can give them tools to help them deal with their stress, they are more likely to deal with and overcome their addictions.”
Jason agrees. Cenikor’s residential program helped him change his behavior through structure, accountability and responsibility. Mindfulness-Based Stress Reduction helped him deal with the physical and emotional stresses that came with that behavior change. “So many things that were done in the past were on my mind,” he says. “I had so much guilt and so much shame. I had put myself in some very dangerous situations. I was stealing cars and ripping off my family. Then I started worrying about how I was going to get my life in order.”
In the past, he likely would have used crack cocaine to deal with the pressure. Now he knew that he needed to stop, take a breath, observe and then proceed.
“Individuals in recovery benefit from learning how to build a new life by living in the moment,” Marcus says.
As she continues her research, Marcus hopes that one day Mindfulness-Based Stress Reduction is fully integrated into drug and alcohol treatment programs.
“Treatment works. Sometimes people think it is hopeless, but treatment and prevention do work,” she says. “You do not have to hit rock bottom, and we can interrupt the process.”
Jason is a believer. He has been clean for more than three years, and now he is helping other addicts get back on their feet. He is now a licensed chemical dependency counselor and is pursuing a degree in clinical psychology. He also has restored his relationship with his mother.
“I’m still putting back the pieces of the broken life,” he says. “It takes a strong commitment, and sometimes change is downright uncomfortable.”
That’s when he remembers, “Now bring the focus back to the breath.”