Mindfulness-Based Interventions for the Treatment of Aberrant Interoceptive Processing in Substance Use Disorders

Abstract

Altered interoception, or the processing of bodily signals, has been argued to play a role in the development and maintenance of substance use disorders (SUD). Therefore, interoceptive interventions focusing on bodily awareness, such as mindfulness meditation, may improve treatment outcomes for individuals with SUD. Here we review: (1) subjective, behavioral and brain evidence for altered interoceptive processing in SUD, focusing on insular and anterior cingulate cortices (INS, ACC), key regions for interoceptive processing; (2) research highlighting links between mindfulness and brain function; and (3) extant brain research investigating mindfulness-based interventions in SUD. SUD tend to be characterized by heightened INS and ACC responses to drug cues but blunted interoceptive awareness and attenuated INS and ACC responses during tasks involving bodily attention and/or perturbations. In contrast, mindfulness interventions in healthy individuals are linked to enhanced INS and ACC responses and heightened interoceptive awareness. It is crucial for future research to identify: (1) whether mindfulness-based treatments are efficacious across substance classes; (2) what particular approaches and dosages show the largest effect sizes in enhancing INS and ACC function to non-drug stimuli and reducing responsivity to substance cues, thereby improving SUD treatment outcomes (reducing drug craving and relapse).

Nursing Interventions in the Management of Mental Health and Alcohol Use Disorders: A Comprehensive Review

“…For example, mindfulness-based interventions (MBIs) have shown promise in this population and effectively reduced depression and alcohol cravings [33][34][35][36]. So, healthcare providers can consider MBIs as adjuvant treatments to alleviate depression and alcohol cravings [36,37]. Also, Cognitive-Behavioral Interventions (CBIs) have shown potential for managing MHDs and substance use [38,39].…”

Mindfulness, Interoception, and the Body

“…May and colleagues [ 25 ] provide new insights on the role of interoceptive dysfunctions in the development and maintenance of substance use disorders, and the potential utility of mindfulness-based interventions for the treatment of interoceptive symptoms in substance use disorders. In reviewing these themes, May and colleagues [ 25 ] suggest that substance use disorders may be typified by exaggerated responses in the insula and anterior cingulate cortices to drug-specific cues, but diminished behavioural performance and attenuated activity in the insula and anterior cingulate cortices during interoceptive tasks.…”

“…May and colleagues [ 25 ] provide new insights on the role of interoceptive dysfunctions in the development and maintenance of substance use disorders, and the potential utility of mindfulness-based interventions for the treatment of interoceptive symptoms in substance use disorders. In reviewing these themes, May and colleagues [ 25 ] suggest that substance use disorders may be typified by exaggerated responses in the insula and anterior cingulate cortices to drug-specific cues, but diminished behavioural performance and attenuated activity in the insula and anterior cingulate cortices during interoceptive tasks. Furthermore, May and colleagues [ 25 ] interrogate the limited research utilising mindfulness-based interventions in substance use disorders, which suggests that mindfulness-based interventions hold promise for the treatment of substance use disorders, but require further scrutiny to optimise the selection of approaches and doses, and to identify whether treatments are effective across different substance classes.…”