The Effects of Meditation on Alcohol Use and Recidivism

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The Effects of Meditation on Alcohol Use and
Recidivism

• G. Alan Marlatt, Ph.D.
• Addictive Behaviors Research Center
• Department of Psychology
• University of Washington
• VM 206.685.1200 E-mail abrc_at_u.washington.edu
• http//depts.washington.edu/abrc/marlatt_presentat
  ions.htm

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Project Choices Team

• PRINCIPAL INVESTIGATOR G. Alan Marlatt, PhD
• CO-PRINICIPAL INVESTIGATORS Mary Larimer, PhD
  Arthur Blume, PhD
  Tracy Simpson, PhD
• RESEARCH COORDINATORS George A. Parks, PhD
  Jessica M. Cronce
• GRADUATE RESEARCH ASSISTANTS Tiara Dillworth
• Sarah Bowen
• Laura MacPherson
  Katie Witkiewitz
• POST DOCTORAL RESEARCH ASSOC. Heather Lonczak,
  PhD

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Introduction

• From 1970 to 1997, the number of
  substance-involved offenders in the Federal
  Bureau of Prisons has increased from 16 of
  prisoners in 1970 to over 60 in 1997.

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Introduction

• There is evidence that other spiritual
  interventions besides AA, particularly
  meditation-based interventions, are associated
  with reduced alcohol and substance use.

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Introduction

• Two types of spiritually-based meditation
  techniques, Transcendental Meditation (TM), and
  to a lesser extent Vipassana meditation, have
  been evaluated as treatments for substance abuse,
  with encouraging results (Alexander et al., 1994
  Marlatt, 1994 Marlatt Kristeller, 1998).

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Introduction

• Marlatt et al. (1984) found Transcendental
  Meditation, progressive relaxation, and
  bibliotherapy showed significant reductions in
  alcohol consumption in heavy social drinkers
  during the treatment and follow-up period
  compared to the no-treatment control
  participants.

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Introduction

• Vipassana meditation, the intervention addressed
  in this study, is rooted in traditional Buddhist
  teachings and has been made available to
  practitioners around the world by the revered
  Buddhist teacher, S. N. Goenka (Hart, 1987).

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Introduction

• Preliminary results from research with inmate
  populations in India indicate that Vipassana
  meditation helps in reducing recidivism, reducing
  psychopathological symptoms, and increasing more
  positive behaviors such as cooperation with
  prison authorities (Chandiramani et al., 1995
  Kumar, 1995 and Vora, 1995).

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Introduction

• The first Vipassana course in a North American
  correctional facility was conducted at the North
  Rehabilitation Facility (NRF) near Seattle,
  Washington in 1997.

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Introduction

• Prior to closing in the fall of 2002, NRF was a
  minimum-security jail facility with an adult male
  and female inmate population of approximately
  300.
• Between January 2001 and November 2002,
  participants in 9 ten-day courses at NRF were
  invited to participate in the study.

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Research Aims

• Document the effectiveness of a specific
  spiritual practice, Vipassana Meditation, on
  mental health, spiritual outcomes, and reduction
  of alcohol and drug use, alcohol-related negative
  consequences, and criminal recidivism in a
  correctional population.

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Participants

• 305 participants, 244 men and 61 women, agreed to
  participate in the study while incarcerated at
  NRF.
• Participants completed a baseline assessment
  (N305), attended the Vipassana course or
  participated in treatment as usual, completed a
  post-course assessment (n176), and a follow-up 3
  months after release (n87).

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Most common charges/convictions(in order of
frequency)

• 1. Driving Under the Influence of Intoxicants
• 2. Theft
• 3. Violation of the Uniform Controlled Substance
  Act (VUCSA)
• 4. Driving with License Suspended (typically
  suspended due to previous DUI)
• 5. Assault/Domestic Violence
• 6. Possession of Stolen Property
• 7. Harassment
• 8. Prostitution
• 9. Criminal Trespass
• 10. Hit and Run

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Procedure

• Participants self-selected to participate in the
  10-day Vipassana meditation course
• Inmates could participate in the Vipassana course
  and not participate in the research study
• Participants in both the Vipassana and control
  conditions completed baseline measures
  approximately 1 week prior to the first day of
  the Vipassana course
• All participants completed a post-course
  assessment approximately 2-3 days after the last
  day of the Vipassana course while still
  incarcerated

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Procedure

• Participants who completed both baseline and
  post-course were eligible for 3-month follow-up
  (59 Vipassana 107 control)
• 29 Vipassana participants 58 participants in
  the control group completed the 3-month follow-up
  
• Case-matching of Vipassana and control
  participants was performed using propensity
  scores based on gender, age, education, religious
  background, treatment participation and previous
  employment

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Baseline Only AssessmentParticipant
Characteristics

• 63 Caucasian, 10 Native American, 9 Latino, 8
  African-American, 3 Asian, 7 other
• Average age 37.8 years old
• 56 employed at least part-time prior to
  incarceration
• 79 GED or high school diploma
• 58 Christian, 17 no formal religion, 25 other
• 26 attended religious services more than 1x
  month, 34 less than 1x month, 40 never
• Criminal history
• PTSD
• Attrition analysis revealed no significant
  baseline differences between the original sample
  (n305) and the case-matched sample (n58)

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Baseline Follow-up AssessmentsSpiritual and
Religious Domains

• LOT-Optimism
• RBBQ-Religious Beliefs and Behaviors
  Questionnaire
• RCAS-Religious Coping Scale
• Meaning Scale
• DES-Daily Spiritual Experiences Scale
• Results included in this presentation

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Baseline Follow-up AssessmentsAlcohol Use

• DDQ-R Daily Drinking Questionnaire
• Alcohol Q/F Index
• AUDIT-Screening
• ADS - Dependency
• DRIE Locus of Control
• ICS Impaired Control
• SIP-2R Consequences

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Baseline Follow-up AssessmentsDrug Use

• DDTQ Daily Drug-taking Questionnaire
• ASI Quantity/frequency of AOD
• DAST Drug Dependency

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Baseline Follow-up AssessmentsThinking,
Motivation, Distress

• Marlowe-Crown Social Desirability
• SRQ Self-Regulation Questionnaire
• WBSI White Bear Suppression Inventory
• RCQ Readiness to Change Questionnaire
• BSI Psychopathology Screening

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Follow-up only AssessmentRecidivism and A/D
Relapse

• Form 90 Timeline Followback
• Recidivism

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Analyses

• Analyses of covariance were conducted,
  controlling for baseline scores, to explore the
  effect of the meditation intervention on a
  variety of the psychosocial and alcohol/drug use
  dependent variables.
• Recognizing that running multiple significance
  tests may inflate Type I error rates, future
  reports of the complete data set will use a
  Bonferroni corrected alpha level.
• However, given the small sample size and
  exploratory nature of these analyses, results
  that were significant at p .05 are reported.

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Changes from Pre-Course to 3-month Follow-up
Group x Time Interaction Effects
Measure/Domain F p Locus of control
(DRIE) 7.11 .010 Self Regulation
(SRQ) 6.35 .016 Optimism (LOT) 5.97 .018
drinking days (ASI) 4.50 .039 ETOH
consequences (SIP total) 5.67 .021 Peak weekly
alcohol use 5.47 .023 Peak weekly powder
cocaine use 4.15 .047 Peak weekly crack cocaine
use 5.21 .027
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Changes from Pre-Course to 3-month Follow-up
Self-Regulation
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Changes from Pre-Course to 3-month Follow-up
Number of Drinking Days
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Changes from Pre-Course to 3-month Follow-up
Peak Weekly Crack Cocaine Use
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Changes from Pre-Course to 3-month Follow-up
Peak Weekly Cocaine Use
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Changes from Pre-Course to 3-month Follow-up
Alcohol Negative Consequences
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Changes from Pre-Course to 3-month Follow-up
Locus of Control
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Changes from Pre-Course to 3-month Follow-up
Peak Weekly Alcohol Use
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Changes from Pre-Course to 3-month Follow-up
Optimism
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Discussion

• To be mindful is to be aware of the full range of
  experiences that exist to bring ones complete
  attention to the present experience on a
  moment-to-moment basis. This is consistent with
  the Buddhist view of transcendence as
  'enlightened awareness of the true being'
  (Goldstein Kornfield, 1987).

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Discussion

• Meditation or Right Mindfulness is presented a
  critical element in the Eight-Fold Path leading
  to the ultimate spiritual goal of enlightenment.

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Discussion

• Alcohol and drug addiction are described in the
  Buddhist literature as problems related to
  ego-attachment, with an emphasis on craving as
  the major process underlying the dynamic of the
  addictive process.

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Discussion

• Groves and Farmer (1994) write
• From its beginning two and a half thousand years
  ago, the central concerns in Buddhism have been
  craving and attachment. Buddhist teachings then
  constitute a rich source of etiological models
  and possible therapies for addictions.

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Discussion

• Groves and Farmer (1994) describe Vipassana
  meditation as a means of overcoming addiction
  problems In the context of addictions,
  mindfulness might mean becoming aware of triggers
  of craving, and choosing to do something else
  which might ameliorate or prevent craving, so
  weakening this habitual response

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Discussion

• The process of meditation can thus lead to both
  the alleviation of addiction and the development
  of spiritual growth toward eventual
  enlightenment.

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Thank You!