Studies have shown the benefit of mindfulness training added to substance abuse treatment. Now a study from the National Institutes of Health shows that lack of mindfulness may be one of the causes of substance abuse, in the first place.

The study calls mindfulness, a “way of being that is focused on the present moment in a non-judgmental, non-reactive, compassionate manner.” The researchers looked for mindfulness in a population 107 adults in residential treatment for substance abuse. At the center, addicts filled out a 13-question survey called the Toronto Mindfulness Scale. Really, the scale looks at two components of mindfulness: decentering and curiosity. In decentering, a person can “step back” to observe their thoughts and feelings, rather than being absorbed by them. And in this case, curiosity isn’t just being generally curious about the world around you, but instead is a kind of curiousness about yourself – “the desire to know more about what you are experiencing,” the authors write.

Because the Toronto Mindfulness Scale has also been used to measure mindfulness in people not seeking treatment, the researchers could make an interesting comparison. For non-addicted people, the average score on the decentering part of the scale is 11.93; for people in residential treatment for addiction, it was 6.78. For non-addicted people, the average score on the curiosity side of the scale was 13.72; for people in residential treatment for addiction, it was 5.58.

Overall addicted people had about half the mindfulness as non-addicted people.

The authors point out that low mindfulness scores in addicts may mean that addicts, as a group, have lower tolerance for distressing experiences. “It is possible,” the authors write, “that the substance abuse group employed alcohol/drugs as a way to cope with, or to distance themselves from, distressing emotions and thoughts that they were over-identified with; in essence, substance use may be a form of coping with these distressing experiences.”

The study also suggests why mindfulness-based addiction treatment and mindfulness-based relapse prevention programs work. These programs teach non-judgmental acceptance of and curiosity about experiences that are naturally more positive and more negative. By doing so “each experience can be viewed... as something to be explored and understood, rather than something to be removed or pushed away.”

Of course, the way many addicts “push away” these experiences that currently overwhelm them is through using their substance of choice.

Interestingly, this article supports the idea of treating co-occurring and underlying issues along with addiction. In other words, just as depression and anxiety can cause and reinforce addiction, so too can lack of mindfulness be seen as a “condition” that leads to addiction. By treating anxiety or depression along with addiction, innovative treatment centers are improving recovery rates. And now it seems as if low mindfulness can be added to this list of issues for which directed treatment should be provided. By helping addicts discover the curiosity and decentering of mindfulness, we can treat this condition of low mindfulness that underlies addiction.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.