Sunday, September 19, 2010

Exercise, Attention, Meditation

Drug treatment alternatives.

A prescription for aerobic exercise might seem trivial in the face of the life-or-death battle people wage against rampant addiction. But with or without anti-craving drugs, both diet and exercise—two non-pharmaceutical methods of altering neurotransmission—will have roles to play in recovery.

Exercise, attention to diet, and nutritional supplements are only three of the complementary avenues being explored as components of addiction treatment. Successes have been claimed for acupuncture as well.  The same can be said for hypnosis. It has its vociferous claimants, but it has not been widely tested and documented as an addiction therapy.

Meditation, in its many Eastern and Western derivations, is used by some recovering addicts as a means of dampening the panic and anxiety that often accompany detoxification. And again, there is a certain amount of good science behind the notion. Sources as disparate as Maharishi Mahesh Yogi and Harvard’s Dr. Herbert Benson have produced evidence that sitting meditation—in which the mind is either purposefully made blank, or else is focused on a mantra (the Maharishi’s mantras are Sanskrit, but Dr. Benson maintains that any soft-sounding set of syllables will do)—produces verifiable changes in blood pressure, heart rate, and oxygen exchange. Years ago, Dr. Benson named this phenomenon the “relaxation response.” Many addiction clinics use variations on this theme in an attempt to ease withdrawal symptoms.

All of these alternative modalities suffer from the same limitations: a lack of large scale clinical testing due to inadequate funding, and a lack of adequate insurance reimbursements. Nonetheless, almost anything goes in the sprawling treatment and recovery industry. There are, for example, numerous clinics and treatment centers based on the principles of naturopathic and homeopathic medicine. The 3HO SuperHealth program that bloomed in Tucson, Arizona, a “holistic substance abuse facility” inspired by the teachings of the Hindu Guru Yogi Bhajan, was accepted by Blue Cross/Blue Shield and other major insurance providers. (Gaining insurance accreditation is a major factor in the success or failure of many treatment providers and large-scale programs.) There are drug recovery programs based on the spiritual wisdom of American Indians, on the teachings of the German mystic Rudolf Steiner, on assorted holistic health practices such as yoga, guided imagery, lucid dreaming, biofeedback, massage, and other forms of “personal growth” work.

Alternative therapists maintain that recovery from addiction is as much a spiritual voyage of discovery as it is a path back to conventional health and sanity. Traditional psychotherapy in isolation is a frequently ineffective method of treatment, while anti-craving pills, congeners, and replacement therapies are still quite new.

 Any treatment that claims to work for all addicts all of the time, under all conditions, should be viewed with extreme skepticism. It is safe to say that any commercial treatment program advertising success rates of 50 per cent or more is very probably engaging in short-term follow-ups, and may be seriously misleading the buying public.

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1 comment:

Ed said...

The possibility for meditation as a treatment for addiction goes far beyond relaxation.

Addiction has been shown to change the dopamine pathways in the brain, which likely has an effect on attention, namely making it harder for addicts to focus their attention away from their cravings.

One class of meditation techniques (mindfulness meditation) is all about attention and has recently been shown to increase gray matter in the orbito-frontal cortex ( Interestingly enough, that region is involved in impulse control.

So the ability to relax during withdrawal symptoms is certainly important, but the ability to "tune out" cravings during and after withdrawal is even more important, and meditation may be a tool to do just that.

But as you say, there need to be large scale clinical trials. I hope these trials happen, and I eagerly await the results.

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