The Effects of Vipassana Meditation

on Alcohol & Drug Relapse

and Criminal Recidivism
UW/ABRC

G. Alan Marlatt, Ph.D.

Addictive Behaviors Research Center
Department of Psychology
University of Washington

VM: 206.685.1200 E-mail: abrc@u.washington.edu

http://depts.washington.edu/abrc/marlatt_presentations.htm
 Project Choices Team
UW/ABRC
PRINCIPAL INVESTIGATOR G. Alan Marlatt, PhD

CO-PRINICIPAL INVESTIGATORSMary Larimer, PhD

Arthur Blume, PhD Tracy Simpson, PhD

RESEARCH COORDINATORS George A. Parks, PhD

Jessica M. Cronce

RESEARCH STUDY ASSISTANTS James K. Buder

Tiara Dillworth

GRADUATE RESEARCH ASSISTANTS Laura MacPherson

Katie Witkiewitz
Sarah Bowen
 Introduction
UW/ABRC

From 1970 to 1997, the number of

substance-involved offenders has
increased from 21,266 prisoners in the
Federal Bureau of Prisons with 16%
being drug offenders to 98,483
incarcerated individuals of which over
60% are drug offenders.
 Introduction
UW/ABRC

There is evidence that other spiritual

interventions besides AA,
particularly meditation-based
interventions, are associated with
reduced alcohol and substance use.
 Introduction
UW/ABRC

Two types of spiritually-based

meditation techniques, Transcendental
Meditation (TM), and to a lesser extent
Vipassana meditation, have been
evaluated as treatments for substance
abuse, with encouraging results
(Alexander et al., 1994; Marlatt, 1994;
Marlatt & Kristeller, 1998).
 Introduction
UW/ABRC

Marlatt et al. (1984) found that the

meditation (CSM), progressive
relaxation, and bibliotherapy all lead to
significant reductions in alcohol
consumption during the training
period compared to the no-treatment
control subjects.
 Introduction
UW/ABRC

Vipassana meditation, the intervention

addressed in this study, is rooted in
traditional Buddhist teachings and has
been made available to practitioners
around the world by the revered
Buddhist teacher, S. N. Goenka (Hart,
1987).
 Introduction
UW/ABRC

Preliminary results from research with

inmate populations in India indicate
that Vipassana meditation helps in
reducing recidivism, reducing
psychopathological symptoms, and
increasing more positive behaviors
such as cooperation with prison
authorities (Chandiramani et al., 1995;
Kumar, 1995; and Vora, 1995).
 Introduction
UW/ABRC

 Vipassana has also been

implemented in correctional
facilities within the United States.

 The first Vipassana course in a

North American correctional facility
was conducted at the North
Rehabilitation Facility (NRF) in
Seattle, Washington in 1997.
 Introduction
UW/ABRC

 Prior to closing in the fall of 2002, NRF

was a minimum-security jail facility with
an adult male and female inmate
population of approximately 300.

 Between January 2001 and November

2002, nine ten-day courses were held at
NRF and included in the study.
 Research Aims
UW/ABRC
 Document the effectiveness of a specific spiritual
practice, Vipassana Meditation, for reducing
alcohol and drug relapse, alcohol-related negative
consequences, and criminal recidivism in a
correctional population.
 Evaluate several domains of spirituality as
mediators and moderators of the effectiveness of
Vipassana meditation on alcohol and drug
relapse, criminal recidivism, mental health, and
spiritual outcomes in this population.
 Evaluate participant characteristics as predictors
of willingness to participate in Vipassana
meditation.
 Participants
UW/ABRC
 n=305, 244 men and 61 women recruited from NRF
 61% Caucasian, 11% Native American, 7% Latino/Latina,
13% African-American, 2% Asian, 6% other
 Average age 37.8 years old
 56% employed at least part-time prior to incarceration
 79% GED or high school diploma
 58% Christian, 17% no formal religion, 25% other
 26% attended religious services more than 1x month, 34%
less than 1x month, 40% never
 Most common charges/convictions
(in order of frequency):
UW/ABRC

1. Driving Under the Influence of Intoxicants

2. Theft
3. Violation of the Uniform Controlled Substance Act
(VUCSA)
4. Driving with License Suspended (typically
suspended due to previous DUI)
5. Assault/Domestic Violence
6. Possession of Stolen Property
7. Harassment
8. Prostitution
9. Criminal Trespass
10. Hit and Run
 Procedure
UW/ABRC
 Participants self-selected to participate in the 10-day
Vipassana meditation course
 Inmates could participate in the Vipassana course and
not participate in the research study
 Participants in both the Vipassana and control
conditions completed baseline measures
approximately 1 week prior to the first day of the
Vipassana course
 All participants completed a post-course assessment
approximately 2-3 days after the last day of the
Vipassana course while still incarcerated
 Procedure
UW/ABRC
 Participants who completed both baseline and post-
course were eligible for longitudinal follow-up (59
Vipassana; 107 control)
 Follow-up assessments are administered onsite at the
University of Washington 3- and 6-months post-release
 Thus far, 49 Vipassana participants & 65 participants in
the control group have completed the 3-month follow-up
questionnaire, and 6-month follow-up is underway
 Case-matching of Vipassana and control participants will
occur after data collection is complete, prior to final data
analysis
 Pre-Course (Baseline) Assessment
Participant Characteristics
UW/ABRC

 Age
 Ethnicity
 Education
 Work status
 Religious background and practices
 Criminal history
 PTSD
 Pre-Course (Baseline) Assessment
Spiritual and Religious Domains
UW/ABRC

 LOT-Optimism
 RBBQ-Religious Beliefs and Behaviors
Questionnaire
 RCAS-Religious Coping Scale
 Meaning Scale
 DES-Daily Spiritual Experiences Scale
 Pre-Course (Baseline) Assessment
Alcohol Use (90 days pre-NRF)
UW/ABRC

 DDQ-R Daily Drinking Questionnaire

 Alcohol Q/F Index
 AUDIT-Screening
 ADS - Dependency
 DRIE – Locus of Control
 ICS – Impaired Control
 SIP-2R - Consequences
 Pre-Course (Baseline) Assessment
Drug Use (90 days pre-NRF)
UW/ABRC

 DDTQ – Daily Drug-taking Questionnaire

 ASI – Quantity/frequency of AOD
 DAST – Drug Dependency
 Pre-Course (Baseline) Assessment
Thinking, Motivation, Distress
UW/ABRC

 Marlowe-Crown – Social Desirability

 SRQ – Self-Regulation Questionnaire
 WBSI – White Bear Suppression Inventory
 RCQ – Readiness to Change Questionnaire
 BSI – Psychopathology Screening
 Pre-Course (Baseline) Assessment
Recidivism and AOD Relapse
UW/ABRC

 TLFB (90) – Timeline Followback

 Criminal History/ Recidivism
 Post-Course and Follow-up
Assessments
UW/ABRC

Post-Course Assessment:
 All measures except participant
characteristics and alcohol/drug items

3- & 6-month Follow Up Assessments:

 All measures except participant
characteristics
 Addition of TLFB for AOD Relapse and
Recidivism
 Preliminary Analyses
UW/ABRC

 These analyses only include a subset of the sample

that has completed both baseline and 3-month follow-
up. Additional research participants will be assessed
at 3- and 6-months before final results are available.

 The comparisons reported represent group mean

differences from Time 1 (90 days prior to incarceration,
retrospective) to Time 2 (3-months post-release) and
were calculated before case matching could take place.
Final results will include only Vipassana course
completers and their case-matched controls.
 Preliminary Analyses
UW/ABRC

 Preliminary analyses of variance were conducted

to explore the repeated measures effect of the
meditation intervention on a variety of the
psychosocial and alcohol/drug use dependent
variables.
 Recognizing that running multiple significance
tests may inflate Type I error rates, future reports
of the complete data set will use a Bonferroni
corrected alpha level.
 However, given the small sample size and
exploratory nature of these analyses, results that
were significant at p = .05 are reported.
Changes from Pre-Course to 3-month Follow-up:
Main Effects for Time
UW/ABRC

Measure/Domain F p

Religious Coping Activities 5.55 .02

Meaning Scale 5.15 .03

Peak weekly alcohol use 30.95 .0005

Peak weekly heroin use 8.89 .004

Changes from Pre-Course to 3-month Follow-up:
Group x Time Interaction Effects
UW/ABRC
Measure/Domain F p
Locus of control (DRIE) 4.44 .04
Impaired Control Scale 8.17 .006
Thought suppression (WBSI) 4.57 .04
Optimism (LOT) 13.53 .001
Depression (BSI) 4.54 .04
Hostility (BSI) 4.24 .04
Alcohol consequences (SIP total) 3.95 .05
Drug addiction (DAST) 6.28 .02
Peak weekly tobacco use 5.46 .02
Peak weekly powder cocaine use 9.80 .003
Peak weekly crack cocaine use 4.82 .03
Peak weekly marijuana use 4.21 .04
Changes from Pre-Course to 3-month Follow-up:
Alcohol Related Negative Consequences
UW/ABRC

SIP Total Score SIP Total Score

22

20

18

16
Estimated Marginal Means

14
Treatment Group
12

10 TAU control

8 Vipassana
Baseline 3-months
Changes from Pre-Course to 3-month Follow-up:
Locus of Control
UW/ABRC

.28
DRIE Total Score
.26

.24

.22

.20
Estimated Marginal Means

.18

.16 Treatment Group

.14 Control (TAU)

.12 Meditation (TAU+V)

Baseline 3-months
Changes from Pre-Course to 3-month Follow-up:
Drug Abuse/Dependence
UW/ABRC
16
DAST Total Score
15

14

13

12
Estimated Marginal Means

11

10
Treatment Group

9 Control (TAU)

8 Meditation (TAU+V)
Baseline 3-months
Changes from Pre-Course to 3-month Follow-up:
Psychopathology (Depression)
UW/ABRC
7.0
BSI Depression Scale Score
6.5

6.0

5.5

5.0
Estimated Marginal Means

4.5

4.0
Treatment group

3.5 Control (TAU)

3.0 Meditation (TAU+V)

Baseline 3-months
 Discussion
UW/ABRC

To be mindful is to be aware of the full

range of experiences that exist, to
bring one’s complete attention to the
present experience on a moment-to-
moment basis. This is consistent with
the Buddhist view of transcendence as
'enlightened awareness of the true
being' (Goldstein & Kornfield, 1987).
 Discussion
UW/ABRC

Meditation or “Right Mindfulness” is

presented a critical element in the
Eight-Fold Path leading to the ultimate
spiritual goal of enlightenment.
 Discussion
UW/ABRC

Alcohol and drug addiction are

described in the Buddhist literature as
problems related to ego-attachment,
with an emphasis on “craving” as the
major process underlying the dynamic
of the addictive process.
 Discussion
UW/ABRC

Groves and Farmer (1994) write:

“From its beginning two and a half
thousand years ago, the central
concerns in Buddhism have been
craving and attachment. …Buddhist
teachings then constitute a rich source
of etiological models and possible
therapies for addictions.”
 Discussion
UW/ABRC

Groves and Farmer (1994) describe

Vipassana meditation as a means of
overcoming addiction problems: “In
the context of addictions, mindfulness
might mean becoming aware of
triggers of craving, and choosing to do
something else which might ameliorate
or prevent craving, so weakening this
habitual response…”
 Discussion
UW/ABRC

The process of meditation can thus

lead to both the alleviation of addiction
and the development of spiritual
growth toward eventual enlightenment.
Thank You!