Comparing the efficacy of mindfulness-based relapse prevention versus relapse prevention for alcohol use disorder: A randomized control trial


Objective:

This study compared the efficacy of mindfulness-based relapse prevention (MBRP) with relapse prevention (RP) on reducing alcohol consumption. Secondary, exploratory aims assessed moderation of treatment effects by sex and cannabis use.


Methods:

182 individuals (48.4% female; 21-60 years old) who reported drinking >14/21 drinks/week (for females and males, respectively) in the past 3 months but who wished to quit/reduce their drinking were recruited from Denver and Boulder, CO, USA. Individuals were randomly assigned to 8 weeks of individual based MBRP or RP treatment. Participants completed substance use assessments at baseline, halfway through and at the end of treatment, and 20- and 32-weeks post-treatment. Primary outcomes were alcohol use disorder identification task-consumption (AUDIT-C) scores, heavy drinking days (HDD), and drinks per drinking day (DDD).


Results:

Across treatments, drinking decreased over time (ps<0.05), with a significant time-by-treatment interaction found for HDD (F=3.50, p<0.05). HDD initially decreased in both treatments but remained stable or increased post-treatment for MBRP and RP participants, respectively. At follow-up, MBRP participants had significantly less HDD than RP participants. Sex did not moderate treatment effects (ps>0.05), while cannabis use moderated treatment effects on DDD and HDD (F=4.89, p<0.001 and F=4.30, p<0.005, respectively). High cannabis use frequency was associated with continued post-treatment decreases in HDD/DDD for MBRP participants but increased HDD for RP participants. At low cannabis use frequency levels, HDD/DDD remained stable post-treatment across groups.


Conclusions:

Drinking decreases were comparable across treatments, but HDD improvements diminished for RP participants post-treatment. Additionally, cannabis use moderated treatment efficacy for HDD/DDD.

Clinicaltrials.gov registration number / pre-registration link: NCT02994043 / https://clinicaltrials.gov/ct2/show/NCT02994043?term=NCT02994043&draw=2&rank=1.


Keywords:

alcohol use disorder; cannabis use; mindfulness-based relapse prevention; moderation; relapse prevention; sex.

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