Mindfulness as a therapeutic modality has its principal roots in Buddhism. First introduced by Jon Kabat-Zinn as a treatment for stress and chronic pain, mindfulness-based approaches have since been trialled in a wide range of mental health disorders. Mindfulness may help patients both by teaching them to bring greater awareness to aspects of their experience that they may have avoided, and by helping them to learn to find ways of being with difficult experience that can mitigate suffering. Reviews of studies suggest that mindfulness is most effective in depression and anxiety. As well as helping patients, mindfulness has been recommended to help health professionals to avoid burnout and promote well-being and empathy. Whether therapeutic mindfulness is religious, secular or spiritual has been debated. This ambiguity may allow patients to contextualise mindfulness practices according to their own worldviews.

Mindfulness-based interventions (MBIs), founded on the meditation practices outlined in the Mindfulness-Based Stress Reduction (MBSR) program and historically rooted in contemplative traditions, offer one mental framework to address the unique needs of individuals suffering from the causes and consequences of substance and behavioral addictions. MBIs are considered a third wave of empirically tested psychotherapies following behavioral therapy and cognitive-behavioral therapy, respectively. MBI-proposed targets of change include self-regulation, self-exploration, and self-liberation; together, an important set of mental capacities or skills to break the cycle of addiction. In this chapter, we describe the development of MBIs adapted for a variety of addictions. We focus on MBIs for substance use disorders (SUD) and binge-eating disorder (BED) due to similarities in addictive and neurobiological processes (both may be considered substance addictions, BED as a proxy for food addiction), though other behavioral addictions are also discussed. We then critically review leading experimental trials that test the efficacy of MBIs on mechanisms of addiction and substance use behavior among people diagnosed with SUD and BED. Based on results available to date, treatment effects from MBIs are on par with other clinically accepted treatments. However, several methodological limitations make interpretation of the internal validity and reliability of these results difficult to assess. We discuss strengths and limitations of the state of evidence to date and provide suggestions for future research with an emphasis on treatment fidelity and its role in improving the validity of future study findings. We expect our synthesis to inform the public on the value of applying MBIs to remediate the causes and consequences of addictive behavior.