Clients with AOD use disorders often have thoughts about using or cravings to use. These thoughts are often automatic and tend to escalate when the client becomes aware of them. Similarly, clients who experience depression or anxiety may find that these negative or anxiety-provoking thoughts automatically occur and give rise to further negative or anxiety-provoking thoughts. For clients with co-occurring conditions, this automatic thinking may result in a cycle of negative thoughts and cravings to use.
Mindfulness is a meditative technique that encourages the person to pay attention in the present moment, without judgement, rather than allowing the mind to wander automatically (often to negative thinking) [747, 748]. Regular practice of mindfulness allows a person to develop the capacity to interrupt automatic thought patterns, and be accepting, open, and curious of that experience [749]. Although mindfulness can be a useful practice for everyone, it can be particularly helpful for people with co-occurring AOD and mental disorders by assisting with the development of greater awareness of automatic thinking patterns which can often maintain the mental-health-AOD-use cycle [109, 750]. In general, mindfulness practices involve deliberately focusing on the physical sensations associated with routine activities that are carried out automatically (e.g., walking, eating, and breathing). Mindfulness-based stress reduction and mindfulness-based cognitive therapy are two specific group therapies based on mindfulness techniques [751]. For a more detailed discussion of mindfulness, readers are referred to Ostafin and colleagues [748].
There is evidence of the efficacy of mindfulness for assisting with relapse prevention in AOD use [752], as well as reducing cravings, AOD-related problems, the quantity and frequency of AOD use [753], and avoidance-based coping strategies among people with AOD use disorders [754]. There is also evidence of the efficacy of mindfulness in the treatment of mental disorders [755, 756].