Psychological mechanisms of behavior change in mindfulness-based interventions for substance use disorders: A systematic review.
David I K Moniz-Lewis, Frank J Schwebel, Katie Witkiewitz
✦ AI-curated · Sources linked
In 30 seconds
This preregistered systematic review examined psychological mechanisms of behavior change (MOBC) tested in mindfulness-based interventions for people with diagnosed substance use disorders or substance misuse. It included 23 studies identified through a review conducted from July to September 2023 and updated in December 2025. The evidence supported several potentially complementary mechanisms, including increased awareness and acceptance and reduced craving. However, contextual factors received little attention, and only one study replicated prior work, leaving the evidence base in need of replication and more rigorous testing across populations.
Key findings
- The review included 23 studies testing mechanisms linked to treatment outcomes in mindfulness-based interventions for substance use.
- Greater awareness and acceptance, alongside reductions in craving, were supported as complementary mechanisms of change.
- Contextual factors received little attention, and only one study replicated prior work.
Why it matters
Understanding how mindfulness-based interventions may support change can help clarify which processes are relevant to substance use treatment and guide stronger evaluation of these interventions. The review suggests that awareness, acceptance, and craving reduction warrant further study, while limited replication and attention to sociocultural context constrain confidence that these mechanisms apply consistently across populations.
What to keep in mind
The evidence base is limited by sparse replication and little attention to contextual factors; the review also identifies a need for more rigorous methods to test mechanism validity across populations.