Study Protocol
Title: Mindfulness and Meditation-Based Relapse Prevention for Substance Use Disorders: Research Case Series of Three Participants
Objective: To evaluate the feasibility and preliminary outcomes of an eight-week mindfulness and meditation program for adults with substance use disorders.
Design: Observational case series of three de-identified participants; no randomization or intervention assignment beyond standard program protocol.
Methods: Weekly guided meditation sessions, daily home practice, group discussions on relapse prevention; outcomes measured by Perceived Stress Scale, Five Facet Mindfulness Questionnaire, and qualitative journaling.
Inclusion/Exclusion: Adults ≥18 with a history of SUD, participating in the program, willing to provide de-identified data; exclusion: minors or participants not completing at least 75% of sessions.
Duration: Eight weeks
Ethics: De-identified participants; IRB review not required.
Statistical Analysis Plan
Objective: Summarize participant outcomes and feasibility.
Methods:
   •   Continuous measures (Perceived Stress Scale, Mindfulness Questionnaire) summarized using descriptive statistics (mean, range, percent change).
   •   Relapse outcomes recorded qualitatively and reported as event occurrence.
   •   No inferential statistics due to small sample size.
   •   Data will be de-identified for sharing.
Clinical Study Report
Mindfulness and Meditation-Based Relapse Prevention for Substance Use Disorders: Research Case Series of Three Participants
Cice Rivera, MS, PhD, CAP
Abstract
Mindfulness and meditation-based relapse prevention has emerged as a promising adjunct to standard care for substance use disorders (SUDs). This case series reports on three de-identified participants who completed an eight-week mindfulness and meditation program aimed at reducing stress, improving coping skills, and supporting sustained sobriety. All participants demonstrated improvements in perceived stress and mindfulness scores. Two participants experienced relapse within 10–12 months, while one participant maintained long-term sobriety over 10 years. These findings highlight the feasibility of mindfulness-based interventions in clinical practice and provide descriptive insights to inform larger trials (Bowen et al., 2009; Garland et al., 2017).
Introduction
Substance use disorders remain a significant public health concern due to high rates of relapse and chronicity (McLellan et al., 2000). Traditional interventions often include cognitive-behavioral therapy, pharmacotherapy, and community support; however, relapse rates remain substantial (Marlatt & Donovan, 2005). Mindfulness-based relapse prevention (MBRP) has been developed as an adjunctive intervention to improve self-awareness, reduce stress, and enhance coping skills, thereby supporting long-term recovery (Bowen et al., 2009). This case series aims to describe the outcomes of three participants engaging in an eight-week mindfulness and meditation program, highlighting changes in stress, mindfulness, and relapse behavior.
Methods
Three de-identified participants were enrolled in an eight-week mindfulness and meditation program. The first participant was a 51-year-old female with a history of chronic alcohol use and prior relapses. The second participant was a 45-year-old female with intermittent opioid use who had maintained sobriety for 10 years. The third participant was a 30-year-old male with stimulant use (cocaine weekly for two years) who was participating in his first treatment attempt. The intervention consisted of weekly guided mindfulness meditation sessions, daily home practice, and group discussions focused on awareness, craving management, and relapse prevention skills (Kabat-Zinn, 2003). Outcome measures included self-reported perceived stress using the Perceived Stress Scale, mindfulness assessed with the Five Facet Mindfulness Questionnaire, and relapse behavior monitored through participant journals and clinical interviews (Carmody & Baer, 2008). Ethics review was not required because this case series involved three de-identified participants.
Results
All participants demonstrated notable improvements in perceived stress and mindfulness scores following the eight-week program. The 51-year-old female experienced stress reduction and increased mindfulness skills, yet relapsed within 12 months after the program. The 45-year-old female also showed reductions in stress and increased mindfulness, and she maintained her sobriety over a ten-year period, reflecting long-term stability. The 30-year-old male displayed improvements in stress management and mindfulness awareness but experienced a relapse within ten months. Across all participants, qualitative observations indicated enhanced self-awareness, better emotional regulation, and increased engagement with coping strategies learned during the program. These descriptive findings support the feasibility and potential clinical benefits of mindfulness-based relapse prevention in a small clinical sample.
Discussion
This case series demonstrates that mindfulness and meditation-based interventions can be feasibly implemented in clinical settings for individuals with substance use disorders. Improvements in stress reduction and mindfulness skills were observed across all participants, suggesting that mindfulness-based interventions may enhance coping strategies and support recovery (Bowen et al., 2009; Garland et al., 2017). Relapse occurred in two participants within one year, indicating that while mindfulness may improve self-regulation and awareness, additional support and ongoing interventions may be necessary for sustained recovery. The 45-year-old participant’s long-term sobriety highlights that mindfulness practices can complement pre-existing recovery strategies effectively. Although the sample size is small and descriptive in nature, this case series provides important clinical insights and demonstrates the potential utility of mindfulness-based relapse prevention for SUDs. These observations can inform future larger-scale trials, including randomized controlled designs, to evaluate efficacy and long-term outcomes (Chiesa & Serretti, 2014).
References
   •   Bowen, S., Chawla, N., & Marlatt, G. A. (2009). Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. Guilford Press.
   •   Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms, and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23–33.
   •   Chiesa, A., & Serretti, A. (2014). Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Substance Use & Misuse, 49(5), 492–512.
   •   Garland, E. L., Farb, N. A., Goldin, P. R., & Fredrickson, B. L. (2017). Mindfulness broadens awareness and builds eudaimonic meaning: A process model of mindful positive emotion regulation. Psychological Inquiry, 28(4), 293–314.
   •   Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology: Science and Practice, 10(2), 144–156.
   •   Marlatt, G. A., & Donovan, D. M. (2005). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.
   •   McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689–1695.