Mindfulness-Based Interventions for Adolescent Substance Use and Substance Use Disorders: A Systematic Review

CONTEXT: Given the large treatment gap and modest response to contemporary drug treatment approaches for adolescents, interest in mindfulness-based interventions (MBI) for this population is growing. OBJECTIVE: To systematically review the extant literature on the efficacy of MBIs in reducing alcohol/drug use and improving psychological functioning in youth who use substances (YWUS) using PRISMA guidelines. DATA SOURCES: PubMed, EMBASE, Cochrane Library, PsycINFO, and Web of Science. STUDY SELECTION: Selected studies used randomized controlled trial (RCT) designs to compare the efficacy of an MBI to a comparator intervention on substance-related outcomes in samples of YWUS (12-21 years). DATA EXTRACTION: Extracted data included design features, sample characteristics, outcome variables, source measures, and characteristics of MBI and control conditions. RESULTS: After reviewing 2090 citations, we identified 23 eligible studies reporting results from 21 trials with 2297 participants. There was a high degree of heterogeneity across designs, analytic approaches, MBI types, and populations studied. Over two-thirds of studies reported positive results favoring MBI over comparator conditions for postintervention substance use reductions and pooled substance use outcomes. Subgroup results provided preliminary evidence that MBI may reduce impulsivity and alter responses to stress and craving, and that these changes may mediate the relationship between MBI receipt and substance outcomes in YWUS. LIMITATIONS: Few studies examined intervention impacts on illicit substances, and heterogeneity of interventions and outcomes limited the ability to generalize findings. CONCLUSIONS: Our results indicate that MBIs can produce small to moderate reductions in alcohol/drug use and may improve impulsivity and stress reactivity in YWUS.