Gurrieri Laura, Wardle Margaret C, Garland Eric L
Psychology Department, University of Illinois Chicago, Chicago, USA.
Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, USA.
Subst Use Misuse. 2025 Sep 2:1-5. doi: 10.1080/10826084.2025.2525379.
: 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. : 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. : Participants ( = 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 revealed a significant Group-X Time interaction, = 7.06, =.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 (=.61), indicating that the effect of MORE did not significantly vary by condition. : 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.
多种物质使用在酒精使用障碍（AUD）中很常见，且与不良治疗结果相关。经常与酒精共同使用的大麻和可卡因，没有获批的药物治疗方法，对常见行为治疗的反应也很差。因此，迫切需要能够在治疗AUD的同时减少这些物质使用的治疗方法。我们测试了以正念为导向的康复强化疗法（MORE），一种将正念、认知行为技术和品味自然奖励相结合的循证团体治疗方法，是否能同时减少对大麻和/或可卡因的渴望。鉴于MORE在治疗其他成瘾行为方面已证明的疗效，我们假设它会减少患有AUD的人对大麻和/或可卡因的渴望。参与者（n = 50）是患有AUD且同时使用可卡因和/或大麻的成年人。参与者被随机分配到为期十节的MORE或支持性团体（SG）心理治疗对照条件组，两者均针对AUD。在由静息基线、5分钟应激意象暴露、5分钟酒精意象暴露和5分钟恢复期组成的线索反应协议期间，在治疗前后评估非法物质渴望。结果显示出显著的组×时间交互作用，F = 7.06，p =.008，表明随机分配到MORE组的患者在整个线索反应协议中从治疗前到治疗后报告的非法物质渴望显著降低。然而，组×时间×条件交互作用不显著（p =.61），表明MORE的效果在不同条件下没有显著差异。这项初步研究的结果表明，MORE可能会减少多种物质使用和AUD患者的非法物质渴望。MORE应在针对大麻和可卡因使用障碍的全面随机临床试验中进一步评估。
