Professional Care: Complementary and Integrative Health

Complementary and integrative health (CIH) practices (sometimes described as mind-body practices) are a heterogeneous group of therapeutic modalities that may provide benefit, especially when added to the traditional treatments for SUDs.  They can also be effective for improving self-care, which is vital to SUD recovery.  CIH therapies include meditation, deep breathing, Guided Imagery, massage, movement therapies, relaxation techniques, acupuncture, yoga, tai chi, qi gong, hypnotherapy, music therapy, supplements, and herbals.  Overall, research on complementary and integrative interventions as treatments for SUDs is limited by a relatively modest number of clinical trials, especially randomized clinical trials (RCTs), addressing a given intervention, with small sample sizes, and heterogeneity and limitations of the utilized methodology.  The RCT design is considered “gold standard” for evaluating efficacy of therapeutic modalities.  Rigorous design (e.g., RCT), adequate power (appropriate sample size for testing of a given hypothesis), and high-quality study conduct are crucial for reducing the risk of bias and error and ability to draw accurate conclusions.  Therefore, more adequately powered, rigorous RCTs are needed to establish conclusive evidence on the efficacy of the majority of complementary approaches.  For additional information, refer to “Complementary Approaches: A Glossary and Where You Can Learn More” and “Substance Use Disorder Treatment: Complementary and Integrative Health Approaches”  Integrative Health tool.

Overall, although many CIH practices are safe for most people, it is best for patients to consult with their clinical teams prior to engaging in a particular CIH modality. For example, caution may need to be taken with any type of meditation practice in those with underlying substantial mental health issues (e.g., untreated PTSD); these patients should consult with their mental health clinician before beginning a meditation program.

Mindful-Awareness Meditation

Mindfulness meditation is a practice that trains the mind in applying nonjudgmental attention and acceptance to present moment experiences (Please see “Mind and Emotions” section in Part II for more details). In recent years, mindfulness-based interventions have become the most commonly evaluated and applied meditation interventions in clinical and nonclinical settings, with research supporting their efficacy for various mental health and physical health conditions, including SUD.^1-5  In addition to its potential positive impact on recovery outcomes, mindfulness meditation-based interventions have shown benefits for depression, anxiety, pain, and stress coping, and may be effective for PTSD symptoms,^1,6,7 all common problems among Veterans and documented relapse risk factors in SUDs and addiction. ⁸