Mindfulness-Based Relapse Prevention for Substance Use
What mindfulness-based relapse prevention is, what trials and Cochrane found for substance use, why evidence is mixed, and why it supports rather than replaces treatment.
Content last updated . This page has not been medically reviewed.
If you or someone you know is in crisis, call or text 988 in the US. The 988 Lifeline says it can help with mental health struggles and with alcohol or drug use concerns. [1] Call 911 in an emergency. This page is information only. Mindfulness-based relapse prevention is meant to follow professional treatment, never replace it.
What it is
Mindfulness-based relapse prevention (MBRP) is a group-based aftercare program for people who have already completed initial treatment for a substance use disorder. It combines practices from mindfulness-based programs with cognitive-behavioral relapse prevention. [2] In the main US trial, MBRP was given as 8 weekly group sessions. [2] The authors suggest that targeted mindfulness practice may help people notice and cope with the discomfort of craving or negative mood. [2] That is a proposed explanation, not an established mechanism.
NIDA says there are safe, effective medications and psychotherapies for substance use disorders, and that treatment can help prevent a return to use. [3] For opioid use disorder, medications such as methadone, buprenorphine or naltrexone are the standard of care. [3] MBRP is an add-on to such care, not an alternative.
What research shows
| Question | What the source found | Strength of evidence |
|---|---|---|
| Does MBRP lower relapse after treatment? | 286 people after treatment, 12-month follow-up: MBRP and standard relapse prevention both lowered relapse risk compared with usual aftercare at 6 months; at 12 months MBRP showed fewer days of substance use and less heavy drinking than either [2] | Promising but limited; self-reported use plus urine tests |
| Pooled results for MBRP | 9 trials (901 people): no statistically significant difference in relapse (odds ratio 0.72, 95% confidence interval 0.46 to 1.13); small differences in craving and negative consequences, low-quality evidence [4] | Mixed |
| Mindfulness programs for substance use, all types | Cochrane review of 40 trials: compared with no treatment the evidence is uncertain; compared with other treatments, mindfulness may slightly reduce days of substance use [5] | Mixed to insufficient evidence |
| Craving | 17 trials (1,228 people): pooled effect favored mindfulness, but inconsistency was very high and the quality of evidence low [6] | Insufficient evidence |
| Across mental health conditions | Evidence for mindfulness was most consistent for depression, pain, smoking and addictive disorders [7] | Promising but limited |
Reading these results carefully
- Funding and ties. In the main trial, some authors conduct MBRP trainings for which they receive payment. [2]
- Bias. In the Cochrane review all studies were at high risk of performance bias, because participants know which treatment they receive. [5]
- Comparators matter. The 12-month benefit in the main trial was compared with relapse prevention and usual aftercare, while the pooled analyses found few clear differences. [2][4]
- Safety data are thin. Cochrane said data were unavailable to evaluate adverse events, and the meta-analysis found negligible evidence of adverse events. [5][4]
- What NCCIH says. NCCIH summarizes a 2018 review of 37 studies (3,531 people) that found mindfulness-based approaches significantly decreased craving, and a 2017 analysis of 9 MBRP studies that found MBRP was not more effective at preventing relapse than other treatments. [8]
Overall label: mixed evidence, with some promise as an aftercare add-on.
Finding a program
Treatment for substance use disorders can be outpatient or residential, with individual or group counseling and medication support. [3] Behavioral treatments for alcohol use are provided by licensed therapists. [9] Ask a treatment provider whether MBRP or other mindfulness-based relapse prevention is offered, what training the facilitators had, and how it fits with your medications and counseling. Proper evidence not found, in the sources read, for a regulator specific to MBRP facilitators; NCCIH advises asking about an instructor's training and experience. [8]
Related pages: meditation for addiction and substance use, the programs overview and meditation compared with medication and therapy.
Frequently asked questions
Can mindfulness replace addiction treatment?
No. NIDA describes counseling and medications as the treatments for substance use disorders, and the Cochrane review found uncertain evidence for mindfulness against no treatment. [3][5]
Does MBRP prevent relapse?
One large trial found benefits at 12 months, but pooled analyses did not find a statistically significant difference in relapse. [2][4]
How long is an MBRP program?
The main trial used 8 weekly group sessions. [2]
Does mindfulness reduce cravings?
Some studies found lower craving, but a 2023 review found very high inconsistency and low-quality evidence. [6]
Is it safe?
Few trials measured adverse events, so safety information is limited. [5]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Who should check first
Anyone with active substance use, withdrawal symptoms or a recent relapse should speak with a doctor or addiction treatment provider before relying on a mindfulness program. NIDA notes that when people first stop using drugs, they can experience physical and emotional symptoms, including sleeplessness, depression and anxiety, and strong cravings. [3] Do not use meditation to replace conventional care or to postpone seeing a provider. [8] If practice stirs up trauma memories or intense distress, pause and tell your clinician; see meditation difficulties and distressing experiences.
References
- 988 Suicide & Crisis Lifeline. 988lifeline.org. Read 2026-10-22.
- Bowen S, et al. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry. 2014. Read 2026-10-22.
- National Institute on Drug Abuse. Treatment of substance use disorders (DrugFacts). Read 2026-10-22.
- Grant S, et al. Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis. J Addict Med. 2017. Read 2026-10-22.
- Goldberg SB, et al. Mindfulness-based interventions for substance use disorders. Cochrane Database Syst Rev. 2021. Read 2026-10-22.
- Demina A, et al. Mindfulness interventions for craving reduction in substance use disorders and behavioral addictions: systematic review and meta-analysis of randomized controlled trials. BMC Neurosci. 2023. Read 2026-10-22.
- Goldberg SB, et al. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2018. Read 2026-10-22.
- National Center for Complementary and Integrative Health. Meditation and Mindfulness: Effectiveness and Safety. Read 2026-10-22.
- National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder. Read 2026-10-22.