Background and development

Mindfulness in Early Addiction Recovery (MEAR) has been developed in SMART Howard House detoxification unit in Oxford, UK, a ten-bedded residential unit for people detoxing from alcohol and/or opioids, and often other substances too. Howard House is largely funded by Oxford City Council, and admits people for approximately twelve weeks, while they undergo medical reduction/ detoxification at a pace that makes it as comfortable as possible for them, alongside a therapeutic groupwork programme which includes mindfulness, and one-to-one support from a keyworker, with optional counselling sessions. Residents are referred by the community addiction services, meaning there is a wide range of people, from those who have been homeless for some time, to those who have careers and families.

Many treatment services offering mindfulness programmes for addiction are designed for those later in their recovery journeys, often requiring a certain level of stability before they start, and there has been scepticism about doing it this early, especially during a medical withdrawal from substances. There are people at different stages of detox in any one session, there are new admissions and discharges most weeks, and people are not always motivated to attend the sessions: they agree to take part when they come in for detox, but it can often be the last thing they feel like doing as their detox progresses. They may have trauma histories which can make it very difficult for them to sit with their experience, and they can find they have emerging undiagnosed mental health, physical, neurological or cognitive problems, which may have been masked by substance use, often for many years.

Therefore adaptations are needed to the existing mindfulness courses, which tend to be closed groups, and can involve inviting people to sit in silence for up to 40 minutes at a time. This course has been designed to be as safe and sensitive to trauma or emerging mental health problems as possible, whilst still enabling those who take part to learn valuable lessons. I am currently developing the course, helped by my research into the balance between the two elements of safety and effectiveness – which will be published in 2021 and has been funded by the Society for the Study of Addiction. A colleague is running the same programme in a rehabilitation centre in Antwerp, and will also be researching outcomes and safety.

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